Skip to main content
SpringerLink
Log in

Bacteriological study of transhepatically aspirated bile

Relation to cholangiographic findings in 295 patients

  • Original Articles
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

The purpose of this study was to elucidate the frequency of bacterial infection of intrahepatic bile in relation to biliary tract pathology. Bile was aspirated during percutaneous transhepatic cholangiography, with or without combined biliary tract drainage, and subjected to bacteriological investigations in 295 patients with various hepatobiliary diseases. Bile was infected in 89% of the 92 patients who had high fever and were on antibiotics at the time of study. Positive cultures were obtained in 39% of the patients who were not so ill as to require antibiotics. The overall incidence of biliary infection was 90% in bile duct stones, particularly high in patients with primary intrahepatic stones, regardless of the presence of stones in the common bile duct, and in patients who had dilation of the common bile duct, presumably due to obstructive involvement of the ampulla of Vater.E. coli andKlebsiella were the most frequent among the aerobic species isolated, and mixed infection involving these organisms was common. Anaerobes were much less frequent, always mixed with aerobes, but positive cultures would increase with more rigorous anaerobic conditions for culture. Duodenal fluid collected simultaneously did not always grow the same microorganisms, but showed a 86–87% coincidence with intrahepatic bile in terms of positive or negative cultures. It is recommended that bile be cultured at the time of percutaneous transhepatic cholangiography.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Okuda K, Tanikawa K, Emura T, Kuratomi S, Jinnouchi S, Urabe K, Sumikoshi T, Kanda Y, Fukuyama Y, Musha H, Mori H, Shimokawa Y, Yakushiji F, Matsuura Y: Nonsurgical, percutaneous transhepatic cholangiography—diagnostic significance in medical problems of the liver. Am J Dig Dis 19:21–36, 1974

    Google Scholar 

  2. Ferrucci JT Jr, Wittenberg J, Sarno RA, Freyfuss JR: Fine needle transhepatic cholangiography: A new approach to obstructive jaundice. Am J Roentgenol 127:403–407, 1976

    Google Scholar 

  3. Ohto M, Ono T, Tsuchiya Y, Saisho H: Cholangiography and Pancreatography. Tokyo, Igaku-Shoin, 1979, pp. 10–16

    Google Scholar 

  4. Glenn F, Moody FG: Intrahepatic calculi. Ann Surg 153:711–723, 1961

    Google Scholar 

  5. Balasegaram M: Hepatic calculi. Ann Surg 175:149–154, 1972

    Google Scholar 

  6. Nakayama F, Furusawa T, Nakama T: Hepatolithiasis in Japan: Present status. Am J Surg 139:216–220, 1980

    Google Scholar 

  7. Keighley MRB, Burdon DW: Identification of bacteria in the bile by duodenal aspiration. World J Surg 2:255–259, 1978

    Google Scholar 

  8. Lennette EH, Balows A, Hausler WJ, Truant JP: Manual of Clinical Microbiology, 3rd ed. Washington, DC, American Society of Microbiology, 1980, pp. 83–375, 397–445

    Google Scholar 

  9. Chetlin SH, Elliott DW: Biliary bacteremia. Arch Surg 102:303–307, 1971

    Google Scholar 

  10. Pyrtek LJ, Bartus SA: An evaluation of antibiotics in biliary tract surgery. Surg Gynecol Obstet 125:101–105, 1967

    Google Scholar 

  11. Mason R: Bacteriology and antibiotic selection in biliary tract surgery. Arch Surg 97:533–537, 1968

    Google Scholar 

  12. Fukunaga FH: Gallbladder bacteriology, histology, and gallstone. Arch Surg 106:169–171, 1973

    Google Scholar 

  13. Cox JL, Helfrich LR, Pass HI, Osterhaut S: The relationship between biliary tract infection and postoperative complications. Surg Gynecol Obstet 146:233–236, 1978

    Google Scholar 

  14. Deliaris PG, Michail PO, Klonis GD, Haritopoulos NC, Golematis BD, Dreiling DA: Biliary bacteriology based on operative bile culture. Am J Gastroenterol 68:51–55, 1977

    Google Scholar 

  15. Flemma RJ, Flint LM, Osterhaut S, Shingleton WW: Bacteriologic studies of biliary tract infection. Ann Surg 166:563–572, 1967

    Google Scholar 

  16. Saik RP, Greenburg AG, Farris JM, Peskin GW: Spectrum of cholangitis. Am J Surg 130:143–150, 1975

    Google Scholar 

  17. Holman JM, Rikkers LF, Moody FG: Sepsis in the management of complicated biliary disorders. Am J Surg 138:809–813, 1979

    Google Scholar 

  18. Hichey EJ, Couper CE: Acute obstructive suppurative cholangitis. Am J Surg 117:62–68, 1969

    Google Scholar 

  19. Anderson RE, Priesley JT: Observations on the bacteriology of choledochal bile. Surg Gynecol Obstet 133:486–489, 1951

    Google Scholar 

  20. Goswitz JT: Bacteria and biliary tract disease. Am J Surg 128:644–646, 1974

    Google Scholar 

  21. Lou MA, Mandel AK, Alexander JL, Thadepalli H: Bacteriology of the human biliary tract and the duodenum. Arch Surg 112:965–967, 1977

    Google Scholar 

  22. Dye M, Macdonald A, Smith G: The bacterial flora of the biliary tract and liver in man. Br J Surg 65:285–287, 1978

    Google Scholar 

  23. Lötveil T, Osnes M, Aune S: Bacteriological studies of common duct bile in patients with gallstone disease and juxta-papillary duodenal diverticula. Scand J Gastroenterol 13:93–95, 1978

    Google Scholar 

  24. Jackman FR, Hilson GRE, Smith of Marlow L: Bile bacteria in patients with benign bile duct stricture. Br J Surg 67:329–332, 1980

    Google Scholar 

  25. Scott AJ, Khan GA: Origin of bacteria in bile duct bile. Lancet 2:790–795, 1967

    Google Scholar 

  26. Scott AJ: Progress report. Bacteria and disease of the biliary tract. Gut 12:487–492, 1971

    Google Scholar 

  27. Silen W, Wertheimer M, Kirchenbaum G: Bacterial contamination of the biliary tree after choledochostomy. Am J Surg 135:325–327, 1978

    Google Scholar 

  28. Elkeles G, Mirrizi L: A study of the bacteriology of the common bile duct in comparison with the other extrahepatic segments of the biliary tract. Ann Surg 116:360–366, 1942

    Google Scholar 

  29. Pridgen JE Jr, Aust JB, McInnis WD: Primary intrahepatic gallstones. Arch Surg 112:1037–1044, 1977

    Google Scholar 

  30. Maki T: Pathogenesis of calcium bilirubinate gallstones: Role ofE. coli, β-glucuronidase and coagulation by inorganic ions, polyelectrolytes and agitation. Ann Surg 164:90–100, 1966

    Google Scholar 

  31. Hess W: Benign stenosis of the papilla of vater.In The Papilla Vateri and its Disease. M Classen, J Geenen, K Kawai (eds). Baden-Baden, Gerhard Witzstock, 1979, pp 22–27

    Google Scholar 

  32. Okuda K, Tsuchiya Y: Percutaneous transhepatic cholangiography in the diagnosis of juxtaampullary lesions.In The Papilla Vateri and its Disease. M Classen, J Geenen, K Kawai (eds). Baden-Baden, Gerhard Witzstock, 1979, pp 83–91

    Google Scholar 

  33. Furey AT: Ascending cholangitis. NY State J Med 66:1299–1303, 1966

    Google Scholar 

  34. Roth P, Cohen S: Cholangitis, a review of the literature with a report of an illustrative case. Am J Gastroenterol 53:154–163, 1970

    Google Scholar 

  35. Dineen P: The importance of the route of infection in experimental biliary tract obstruction. Surg Gynecol Obstet 119:1001–1008, 1964

    Google Scholar 

  36. Shou ST, Gibson JB: Experimental cholangitis and cholelithiasis. Br J Exp Pathol 49:563–573, 1968

    Google Scholar 

  37. Graham EA, Perterman MG: Further observations on the lymphatic origin of cholecystitis, choledochitis and the associated pancreatitis. Arch Surg 4:23–50, 1922

    Google Scholar 

  38. Byrne JJ, Berger RL: The pathogenesis of acute cholecystitis. Arch Surg 81:812–826, 1960

    Google Scholar 

  39. de la Maza LM, Maeim F, Berman LD: The changing etiology of liver abscess. JAMA 227:161–163, 1974

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. First Department of Medicine, Chiba University Hospital, 280, Chiba, Japan

    Yasutoshi Suzuki MD, Akio Kobayashi MD, Masao Ohto MD, Yukihiro Tsuchiya MD, Hiromitsu Saisho MD, Kunio Kimura MD, Takanori Ono MD &  Kunio Okuda MD

  2. Central Laboratories of Chiba University Hospital, Chiba, Japan

    Yasutoshi Suzuki MD, Akio Kobayashi MD, Masao Ohto MD, Yukihiro Tsuchiya MD, Hiromitsu Saisho MD, Kunio Kimura MD, Takanori Ono MD &  Kunio Okuda MD

Authors
  1. Yasutoshi Suzuki MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Akio Kobayashi MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Masao Ohto MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yukihiro Tsuchiya MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hiromitsu Saisho MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kunio Kimura MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Takanori Ono MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Kunio Okuda MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Suzuki, Y., Kobayashi, A., Ohto, M. et al. Bacteriological study of transhepatically aspirated bile. Digest Dis Sci 29, 109–115 (1984). https://doi.org/10.1007/BF01317050

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01317050

Keywords

Search

Navigation