[Transfer of piperacillin into the body water and gallbladder tissue in cholestasis]

Acute inflammation becomes severe and the risk of perforation of the gallbladder increases every time gall stone colic occurs in patients with cholelithiasis. In the surgical treatment for these patients, interval operation is said to be preferable to emergency operation in the acute stage. Furthermore, the flow of bile into gallbladder is blocked by incarceration of stones at the neck of the gallbladder and other causes in the acute stage. In this case, therefore, how an antibacterial agent in blood moves to the gallbladder wall is important in suppressing infections of the gallbladder wall. We divided 15 patients with cholelithiasis into cases positive for cholecystogram and negative cases and made a comparative study of piperacillin (PIPC) levels after intravenous drip infusion. PIPC level in bile in the gallbladder was very low in the cases negative for cholecystogram compared with the positive cases. However, no definite difference in levels of the gallbladder tissue was observed between positive for cholecystogram and negative cases. Accordingly, it is concluded that administration of PIPC is not ineffective even in severe cholecystitis in which transference of an antibacterial agent from bile can hardly be expected.