[Microbiological studies before and after endoscopic papillotomy (EPT)]

A microbiological check-up was made on 17 patients with choledocholithiasis while they were undergoing EPT and control ERCP. The endoscopes were contaminated in 56% of the 34 procedures. In 9% of the interventions there were indications that mouth flora had been transferred to the duodeno-biliary region. Bacteriaemia occurred in 3 (17%) patients in connection with EPT. After a mean of four months following EPT, the colony count and the number of germs in the duodenal and biliary juice tended to increase; bacteria of the Klebsiella-Enterobacter-Serratia group became dominant. More than 80% of the bile and blood isolates were sensitive to cefotaxime, cefamandole and co-trimoxazole. To minimize the risk of infection following EPT and ERCP, repeated controls of the disinfection of the endoscopes and periendoscopic antibiotic prophylaxis are suggested.