Impact of bactibilia on the development of postoperative abdominal septic complications in patients with malignant biliary obstruction.

This study was intended to clarify the role of bile bacteria in the development of postoperative septic complications in patients with malignant biliary obstruction. A total of 116 patients with malignant biliary obstruction underwent surgical intervention after biliary decompression. The relation between contaminated ductal bile and postoperative abdominal septic complications was analyzed retrospectively. Such complications developed in 49 patients (42%). Bile-contaminated operations (n = 93) resulted in a higher incidence of septic complications than non-bile-contaminated operations (n = 23; P = 0.009). Patients with pre-operative positive bile culture had a higher incidence of septic complications than those with negative bile culture (P = 0.06). There was a positive correlation between the presence of pre-operative cholangitis and the occurrence of septic complications (P = 0.007). Bacteria found in pre-operative ductal bile were also detected in infected sites of 80% of patients with septic complications. Intra-operative contamination from infected ductal bile plays a critical role in the development of postoperative abdominal septic complications.