Bile bacteria in patients with benign bile duct stricture

In a prospective study of 73 patients undergoing hepatodochojejunostomy for benign bile duct stricture who were covered by antibacterial prophylaxis with gentamicin and cephalolothin, bacteria were cultured from bile sampled at operation in 80 per cent of cases. Aerobic organisms were found in 50 cases (82 per cent) and anaerobic organisms in 11 cases (18 per cent). Seventy-three per cent of the patients with postoperative septic complications had bile cultures positive for anaerobes at operation, and the same organisms were cultured from pus. All patients with anaerobes in the bile at some time in the perioperative period developed postoperative sepsis. Antibacterial prophylaxis with gentamicin and cephalothin, together with specific therapy with drugs effective against anaerobes when indicated, are recommended in the management of these cases.