ASO Author Reflections: Real Prevalence of Microorganisms in Bile in Patients Undergoing Pancreatoduodenectomy

Excerpt

An association between bacterobilia and postoperative complications has been shown in patients undergoing hepatopancreatobiliary surgery.1^–3 We previously demonstrated that preoperative internal drainage such as endoscopic biliary stenting was associated with more frequent positive culture tests in intraoperatively collected bile and resulted in postoperative complications compared with external drainage such as endoscopic nasobiliary drainage.2 Unfortunately, all previous reports regarding bacterobilia, including ours, were based on a conventional culture method to detect the presence of microorganisms; however, this test may underestimate the real prevalence of microorganisms in samples given the difficulty in cultivating certain microorganisms, such as obligate anaerobes (which account for more than 99% of gut microbiota). In addition, the conventional culture method cannot measure the number of microorganisms in bile. Thus, the real contamination status of bile has not been elucidated well. …