Negative short-term impact of intraoperative biliary lavage in patients with hepatolithiasis

作     者：Ou Jiang Rong-Xing Zhou Ke Yang Chun-Xian Cai Yu Liu Nan-Sheng Cheng 

作者机构：Department of Surgical OncologyThe Second People’s Hospital of Neijiang Department of Biliary SurgeryWest China Medical Center of Sichuan University 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2016年第22卷第11期

页      面：3234-3241页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

基　　金：Supported by The Science and Technology Support Project of Sichuan Province No.2014SZ0002-10 and No.2015FZ0076 

主　　题：Hepatolithiasis Biliary lavage Postoperative infection 

摘      要：AIM: To evaluate short-term outcomes following intraoperative biliary lavage for ***: A total of 932 patients who were admitted to the West China Medical Center of Sichuan University between January 2010 and January 2014 and underwent bile duct exploration and lithotomy were retrospectively included in our study. The patients were divided into the lavage group and the control group. Related pre-, intra-, and postoperative factors were recorded, analyzed, and compared between the two groups in order to verify the effects of biliary lavage on the short-term outcome of patients with hepatolithiasis. RESULTS: Amongst the patients who were included, 678 patients with hepatolithiasis were included in the lavage group, and the other 254 patients were enrolled in the control group. Data analyses revealed that preoperative baseline and related intraoperative variables were not significantly different. However, patients who underwent intraoperative biliary lavage had prolonged postoperative hospital stays(6.67 d vs 7.82 d, P = 0.024), higher hospitalization fees(RMB 28437.1 vs RMB 32264.2, P = 0.043), higher positive rates of bacterial cultures from blood(13.3% vs 25.8%, P = 0.001) and bile(23.6% vs 40.7%, P= 0.001) samples, and increased usage of advanced antibiotics(26.3% vs 38.2%, P = 0.001). In addition, in the lavage group, more patients had fever( 37.5℃, 81.4% vs 91.1%, P = 0.001) and hyperthermia( 38.5℃,39.7% vs 54.9%, P = 0.001), and higher white blood cell counts within 7 d after the operation compared to the control ***: Intraoperative biliary lavage might increase the risk of postoperative infection, while not significantly increasing gallstone removal rate.