Study On Bacterial Contamination And Countermeasures In ERCP Treatment

ObjectiveTo prospective analysis of the relationship between infection of biliary tract afterelective ERCP and duodenal fluid contamination by comparing the bacterial cultureresults of bile and duodenal fluid from ERCP, and judge whether preoperative oralgentamicin can reduce the incidence of postoperative infection of biliary tract. At thesame time,analyzing value of using antibiotics after elective ERCP by multiplebile culture.Methods435patients with choledocholithiasis were randomly grouped into group Aand group B. Group A and group B was randomly divided into control group andexperimental group. In group A,,the experimental group,sterile water50ml inpreoperative30min oral16IU containing gentamicin, A control group in sterile water50ml30min preoperative oral not containing gentamicin.. In group B,the experimentalgroup was to use cefotaxime sodium needle2.0g+NS100ml ivgtt Bid halfan hour after ERCP, the control group has no special treatment.ResultsIn group A, the control group of duodenal fluid culture was positive in30cases,including23cases of bile culture-positive; Duodenal liquid culture-negative in85cases,including9cases of bile culture-positive. In experimental group,there were14casesof duodenal fluid culture was positive, including9cases of bile culture-positive; liquidculture-negative in81cases, including7cases of bile culture-positive. Sterile watercontaining gentamicin after oral administration, the positive rate of the experimental groupof duodenal fluid was14.7%(14/95), and the control group, the positive rate was26.1%(30/115), there was significant difference between (P<0.05). In the experimental group，bile culture positive rate was16.8%(16/95), and the control group, the positive rate was27.8%(32/115) compared with statistical significance (P<0.05). In group B,the experimental group,24hour later after ERCP, bile colony count was4865±124CFU/ml,positive rate df bile culture was18.2%, compared with the bile colony count (5376±212CFU/ml) and bile culture positive rate (24.3%) half an hour later after ERCP weresignificantly decreased, the difference was statistically significant (P <0.05). While in thecontrol group, for half an hour,24hours and48hours after ERCP, the bile colony countwas5320±324CFU/ml,5498±254CFU/ml,5369±241CFU/ml, the positive rate ofbile culture was23.6%,26.3%,25.5%, there were no statistical significance among theseresults(P>0.05).ConclusionInfection of biliary tract in patients with Choledocholithiasis undergoing electiveERCP caused by duodenal fluid pollution during operation, preoperative oral gentamicincan reduce the incidence of infection.The positive rate of bile culture after ERCP wasabout25%, so antibiotics wasn’t necessary to be used. If you want to use, within24hours is appropriate, it can reduce the positive rate of bile culture, also can reduce theamount of bacteria in bile, which may reduce the recurrence rate of choledocholithiasis.And prolonged treatment time, does not increase its antibacterial effect.