Search In this Thesis
   Search In this Thesis  
العنوان
The Relation Between Bactobilia And Post-operative Septic Complications In Uncomplicated Cholelithiasis Patients /
المؤلف
El-Sabagh, Mohammed Mabrouk Mohammed.
هيئة الاعداد
باحث / محمد مبروك محمد الصباغ
مشرف / عبد العزيز عباس تعلب
مشرف / محمد عبد الجليل البلشى
مشرف / أحمد سعيد الكيلانى
الموضوع
General Surgery. Gallbladder Diseases. Biliary Diseases.
تاريخ النشر
2023.
عدد الصفحات
75 p. :
اللغة
الإنجليزية
الدرجة
ماجستير
التخصص
جراحة
تاريخ الإجازة
23/11/2023
مكان الإجازة
جامعة المنوفية - كلية الطب - الجراحة العامة
الفهرس
Only 14 pages are availabe for public view

from 84

from 84

Abstract

Gallbladder and biliary tract disease is constant because as they are one of the most common causes of admission to hospital in our environment.
Bile; inspite of being sterile in healthy individuals; in symptomatic gallstone diseases, bactobilia has been reported in 20-46% of the patients who undergo cholecystectomy.
Bactibilia is a common finding in individuals at high risk or with complicated gallstone as in obstruction of the biliary tract, choledocolithiasis, those aged >70 years, those with acute calcular cholecystitis, Afunctional gallbladder, and biliary prostheses. However, there is little data regarding the prevalence of bactibilia in patients who have undergone cholecystectomy due to uncomplicated gallstones.
Bactobilia has been shown to be a risk factor predisposing to postoperative septic complications, which are one of the most important concerns of surgeons, especially in laparoscopic surgery. Wound infection after elective cholecystectomy in uncomplicated symptomatic gallstone ranges from 2.3-20%.
This study was conducted to find the relation between post-operative septic complications and cultural bacteria in bile of uncomplicated gall stone patients.
This prospective randomized study was conducted at Menoufia University Hospital, Shebin Alkom, Egypt and Damanhour National Medical Institute, El-Behera, Egypt on 40 patients with uncomplicated chronic calcular cholecystitis, operated for cholecystectomy at the Department of general surgery. Patient selection for the study was based on clinical diagnosis, ultrasonographic examination findings, laboratory investigations.
Patients with chronic calcular cholecystitis; with normal common bile duct diameter with no impacted stones or gravels; with normal liver functions including liver enzymes, total and direct bilirubin in a ddition to alkaline phosphatase enzymes and those with normal coagulation profile were included in this status. While Patients with obstructive jaundice; with elevated liver enzymes especially total and direct bilirubin; elevated alkaline phosphatase enzyme with old age >65 years old; with coagulopathies; elevated WBCs count and immunosuppressive status were excluded.
Patients of the study were classified into two groups each contained 20 patients underwent cholecystectomy with culture of bile aspirated during operative procedure and sent for culture and sensitivity for bacteria when present.
Patients were followed for the presence of septic complications postoperatively during the first post operative 30 days.
In our study there was no difference between groups of the study regarding age while the age was commonly in the 5th and 6th decades of life.
In each group females were commonly affected than males but there was no statistical difference between both groups regarding gender.
In our study, during operation there was no statistical significance between the two groups regarding blood loss intraoperatively, operative time and complications during operations and rate of conversion from laparoscopic cholecystectomy to conventional cholecystectomy.
In this study, bile culture during operation revealed in bactobilia group, the common organisms were mixed in most cases (70%) followed by streptococci and the least was E.Coli constituting (10%).
In our study, there was no statistical difference between both groups of the study regarding post-operative hospital stay and the post-operative complications.
from our study we concluded that even that the infective complications occurs in presence of bactobilia but they also occurred even in equal percentage in absence of bactobilia.