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담도계 수술에서 담즙의 세균 배양과 예방적 항생제 사용의 임상적 의의

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Author(s)
손병호임정수조두희강구정임태진
Keimyung Author(s)
Kang, Koo JeongLim, Tae Jin
Department
Dept. of Surgery (외과학)
Journal Title
대한외과학회지
Issued Date
1998
Volume
54
Issue
1
Abstract
To assess prophylatic antibiotic usage and the value of an intraoperative bile culture in biliary tract surgery, intraoperative bile cultures were taken in 276 biliary surgical patients during the period from Jan. 1991 to Dec, 1995. The results of bile culture, the isolation of organisms, susceptibility of the microorganisms to antibiotics, and the relationship between a positive culture and postoperative complications were analyzed. The positive culture rate was 56.5%, and the highest culture rate(100%) was seen in patients with combined stones in the gallbladder, the common bile duct and the intrahepatic duct. Hie most common gram negative microorganism was E. coli(44%), and Enterococcus was the most common among the gram positive microorganisms. The effective antibiotics for gram negative organisms were Amikacin, Gentamicin, Tobramycin, and Chloramphenicol; for gram positive organisms, they were Amikacin’ Tetracycline, Gentamicin, and Tobramycin in order of effectiveness. The frequency of wound infection was larger in positive cultures(11.5%) than in negative cultures (2.5%), and the risk factors for positive cultures were old age, obstructive jaundice, a high serum SGOT/SGPT level, and previous biliary tract surgery. In conclusion,we recommend that prophylactic antibiotic treatment be done during the perioperative period for old patients with leukocytosis, obstructive jaundice, cholangitis, or a history previous biliary tract surgery. Antibiotic prophylaxis in biliary tract surgery reduces postoperative infectious complications.
Alternative Title
Clinical Effect of an Intraoperative Bile Culture and Antibiotic Prophylaxis in Biliary Tract Surgery
Keimyung Author(s)(Kor)
강구정
임태진
Publisher
School of Medicine
Citation
손병호 et al. (1998). 담도계 수술에서 담즙의 세균 배양과 예방적 항생제 사용의 임상적 의의. 대한외과학회지, 54(1), 109–116.
Type
Article
ISSN
1226-0058
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/38177
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Surgery (외과학)
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