Incidence of bile infection in patients with choledocholithiasis

Five hundred twenty-two patients who underwent choledochotomy because of biliary lithiasis are discussed herein to assess the relationship of different factors such as advanced age, previous surgery, length of clinical history, to the incidence of bile infection. It has been shown that bile infection is higher in patients of advanced age, previous surgery, and longstanding biliary lithiasis, and that it is also associated with a high incidence of common bile duct dilatation, a high incidence of common bile duct pathological changes, and a high incidence of common bile duct primary stones. From our findings in this study it is postulated that bile infection is a result of biliary stasis, and that for those patient poor drainage of the biliary tree due to dilatation and laxity of the bile duct is a predominant feature. The evidence for the above hypothesis after our barium meal studies seems clear, and thus a drainage procedure supplementary to choledochotomy appears to be warranted for those patients and is highly recommended from the results of this study.