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Purpose <p>This study investigated the trends in bacterial growth and antibiotic resistance patterns in gallbladder bile from patients with acute cholecystitis (AC) undergoing laparoscopic cholecystectomy and analyzed the risk factors for positive bile culture.</p> Methods <p>We conducted a retrospective cohort study of patients with AC who underwent emergency laparoscopic cholecystectomy between January 2012 and December 2024. Bile samples were collected directly from the gallbladder during surgery. Bile cultures and antibiotic susceptibility tests were performed, and risk factors for a positive bile culture were evaluated.</p> Results <p>Among 243 patients, 145 (59.7%) were culture-positive. Patients with a positive culture were older (75.5 vs. 65.0&#xa0;years old, <i>p</i> &lt; 0.001) and had a significantly higher Tokyo Guidelines 2018 severity grade (<i>p</i> = 0.006) and longer hospital stay (<i>p</i> = 0.002) than those with a negative culture. In the multivariate analysis, we identified age ≥ 75&#xa0;years old, preoperative endoscopic retrograde biliary drainage, and creatinine level ≥ 1&#xa0;mg/dL as independent risk factors for a positive bile culture. The six most frequently identified microorganisms were <i>Escherichia coli</i>, <i>Klebsiella</i>, <i>Enterococcus</i>, <i>Clostridium</i>, <i>Streptococcus</i>, and <i>Enterobacter</i>.</p> Conclusion <p>The use of appropriate empiric antibiotics in patients with risk factors for positive bile cultures may reduce the incidence of postoperative complications and the length of hospital stay.</p>

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Clinical impact of bile culture from gallbladder in patients undergoing laparoscopic cholecystectomy for acute cholecystitis

  • 期刊论文

  • 发表日期：

    2025年6月10日

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  • Masashi Utsumi,
  • Masaru Inagaki,
  • Koki Omoto,
  • Naoki Onoda,
  • Koji Kitada,
  • Naoyuki Tokunaga,
  • Kosuke Yunoki,
  • Hiroki Okabayashi,
  • Ryosuke Hamano,
  • Hideaki Miyaso,
  • Yosuke Tsunemitsu,
  • Shinya Otsuka

摘要

Purpose

This study investigated the trends in bacterial growth and antibiotic resistance patterns in gallbladder bile from patients with acute cholecystitis (AC) undergoing laparoscopic cholecystectomy and analyzed the risk factors for positive bile culture.

Methods

We conducted a retrospective cohort study of patients with AC who underwent emergency laparoscopic cholecystectomy between January 2012 and December 2024. Bile samples were collected directly from the gallbladder during surgery. Bile cultures and antibiotic susceptibility tests were performed, and risk factors for a positive bile culture were evaluated.

Results

Among 243 patients, 145 (59.7%) were culture-positive. Patients with a positive culture were older (75.5 vs. 65.0 years old, p < 0.001) and had a significantly higher Tokyo Guidelines 2018 severity grade (p = 0.006) and longer hospital stay (p = 0.002) than those with a negative culture. In the multivariate analysis, we identified age ≥ 75 years old, preoperative endoscopic retrograde biliary drainage, and creatinine level ≥ 1 mg/dL as independent risk factors for a positive bile culture. The six most frequently identified microorganisms were Escherichia coli, Klebsiella, Enterococcus, Clostridium, Streptococcus, and Enterobacter.

Conclusion

The use of appropriate empiric antibiotics in patients with risk factors for positive bile cultures may reduce the incidence of postoperative complications and the length of hospital stay.