Abstract
Infection is a problem in biliary surgery and precautions should be taken to reduce this. A policy for the prophylactic use of antibiotics is essential. Patients who are at risk should be identified by assessment of clinical parameters and/or by duodenal intubation and immediate plating of the bile specimen. The antibiotic should be carefully chosen after consultation with the bacteriology department. Prospective collection of data should begin with specimens of gallbladder wall, bile, and a stone sent for both aerobic and anaerobic culture. The selected antibiotic should be started preoperatively.
Résumé
L'infection est une complication relativement fréquente de la chirurgie biliaire. Toutes les précautions doivent être prises pour l'éviter. L'emploi des antibiotiques à titre prophylactique est essentiel. Les patients qui présentent un risque élevé doivent être identifiés à l'aide des données cliniques et/ou par l'examen bactériologique de la bile obtenue par aspiration duodénale. L'antibiotique doit être alors soigneusement choisi.
Au décours de l'intervention la recherche de germes aérobies et anaérobies au niveau de la paroi vésiculaire, de la bile et des calculs doit être entreprise pour établir l'antibiogramme et sélectionner le meilleur antibiotique.
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Gunn, A.A. Antimicrobial prophylaxis in biliary surgery. World J. Surg. 6, 301–305 (1982). https://doi.org/10.1007/BF01653545
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DOI: https://doi.org/10.1007/BF01653545