Background: This study was performed to investigate the relationship between bactibilia and
postoperative infection in patients undergoing surgery for obstructive jaundice.
Methods: With IRB approval, we prospectively examined 76 patients undergoing surgery
for obstructive jaundice. It was the routine practice of the surgeons performing the operations
to culture the common bile duct bile (CBDB). Rates of postoperative infection were analyzed
with regard to the effect of positive bile cultures and biliary instrumentation preoperatively.
Results: Seventy-one patients had CBDB cultures, 16 of whom had bactibilia. Bactibilia was
present in 15 of 47 (33%) who had preoperative ERCP versus one of 24 (4%) of those without
preoperative ERCP (p = 0.0075). Postoperative infection, including pneumonia, bloodstream,
central venous catheter, surgical site, intraabdominal, and urinary tract infection, occurred in
six of 16 (38%) of those with bactibilia versus four of 55 (7%) of those without bactibilia (p =
0.0071).
Conclusions: Preoperative ERCP was associated with an approximately eightfold increase
in the likelihood of having culture-positive bile at the time of surgery for obstructive jaundice.
Additionally, culture-positive bile at the time of surgery was associated with a greater
than fivefold incidence of postoperative infection.
