Asian Journal of Case Reports in Surgery

Aims: To identify the presence of organism growth in bile culture to determine the need forprolonged antibiotic use.

Case Description: We reported five cases of benign biliary obstruction due to common bile duct stone. All patients presented with abdominal pain in the right upper quadrant for months. On physical examination, tenderness in the right upper quadrant of the abdomen and positive murphy sign were found. The ultrasound examination showed the presence of bile stones in all patients and multiple bile stones in two patients. Cholecystectomy, either laparotomy or laparoscopy, was performed on all patients, and the bile was aspirated for culture examination. The culture examination results of all patients showed that there was no growth of organisms. All patients were not administered post-operative antibiotic therapy, and there were no surgical site infections and post-operative morbidity reported.

Discussion: There was no growth of organisms in the bile; therefore, antibiotics were not administered to all patients. The absence of postoperative antibiotics did not lead to an increase in postoperative infections. Avoiding unnecessary use of antibiotics will reduce the side effects of antibiotics.

Conclusion: In our clinical practices, we found no evidence of bacterial colonization in this benign biliary obstruction case. Bile culture can be performed to determine antibiotic use, thereby avoiding unnecessary use of antibiotics.