Published: 2019-08-28

Bile spillage and bacterobilia as risk factors for surgical site infection after laparoscopic cholecystectomy: a prospective study at tertiary care hospital

Rekha Porwal, Aakanksha Soni, Amit Singh, Shruti K. Somani, Poornima Sagar


Background: Surgical site infection (SSIs), a significant postoperative complication, can lead to considerable patient’s morbidity and mortality.

Methods: The study was conducted in the Department of Surgery, J.L.N. Medical College and Hospitals, Ajmer from January 2017 to September 2018. The study population constituted cases of cholelithiasis diagnosed by ultrasonography that underwent laparoscopic cholecystectomy and fulfilling the inclusion and exclusion criteria. Surgical site infection was graded according to Southampton grading system.

Results: The overall frequency of SSI infection in laparoscopic cholecystectomy was 6%. The occurrence of surgical site infection in patients with bacterobilia was 14.28% which was found to be statistically significant. The SSIs in patients with gall bladder content spillage was found to be statistically insignificant.

Conclusions: The frequency of SSI was more in patients with bacterobilia. The gallbladder content spillage does not lead to an increased occurrence of SSI. 


Surgical site infection, Laparoscopic cholecystectomy, Bacterobilia, Bile spillage

Full Text:



Horan TC, Gaynes RP, Martone WJ, Jarvis WR, Emori TG. CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections. Am J Infect Control. 1992; 20:271-4.

Richards C, Edwards J, Culver D, Emori TG, Tolson J, Gaynes R, et al. Does using a laproscopic approach to cholecystectomy decrease the risk of surgical site infection? Ann Sur. 2003;237:358.

Csendes A, Burdiles P, Maluenda F, Diaz JC, Csendes P, Mitru N. Simultaneous bacteriologic assessment of bile from gallbladder and common bile duct in control subjects and patients with gallstones and common duct stones. Arch Surg. 2002;131:389–94.

Jawien M, Wojkowska Mach J, Rozanska A, Bulanda M, Heczko P. Surgical site infection following cholecystectomy: comparison of procedures performed with and without a laparoscope. Int J Infec Control. 2008;4:1-5.

Suri A, Yasir M, Kapoor M, Aiman A, Kumar A. Prospective study on biliary bacteriology in calcular disease of the gall bladder and the role of common newer antibiotics. Int J Surg. 2010;22.

Ahmad F, Islahi S, Hingora OM, Singh Y. Cholelithiasis – a clinical and microbiological analysis. Int J Sci Stud. 2014;2:40-5.

Koc M, Zulfikaroglu B, Kece C, Ozalp N. A prospective randomized study of prophylactic antibiotics in elective laparoscopic cholecystectomy. Surg Endosc. 2003;17:1716-8.

Valceanu D, Nica C, Sava A, Branea S, Blaj S. The incidence of biliary tract infections in benign gall bladder disease. Timisoara Med. 2005;55:145-7.

Hazrah P, Oahn K, Tewari M, Pandey A, Kumar K, Mohapatra T, et al. The frequency of live bacteria in gallstones. HPB. 2004;6:28-32.