DOI: 10.36347/sasjs.2023.v09i02.012

Pages: 117-121

Background: Hepatolithiasis is usually associated with contaminated bile. In hepatolithiasis, frequently presence of stones and stricture within the intrahepatic bile duct that causes stasis of bile. This bile frequently contaminated with various types of bacteria. So culture and sensitivirty test can find out the nature of bacteria and its antibiogram that can be used as empirical therapy for cholangitis in hepatolithiasis. Materials and Methods: This study was conducted at the Department of Hepatobiliary, Pancreatic & Liver Transplant Surgery of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, with 31 patients with hepatolithiasis who underwent surgical procedure from December 2019 to November 2020 with purposively sampled hepatolithiasis patient. Bile was collected intra- operatively from the bile duct for culture and antibiotic sensitivity. Results: The median age was 38 years (range 25-80 years). There were 19 males and 12 females. Abdominal pain was present in all patients with hepatolithiasis. Out of 31 patients, 24 patients had positive bile culture; E. coli was the most frequent organism (n=13, 41.9%) followed by Klebsiella spp. Colistin, imipenem and Tigecycline (100%), doxycycline (83.3%),amikacin (82.6%), Meropenem & Tazobactam+ Piperacillin (72.7%) and cefepime (66.7%) were sensitive to these organisms. Conclusion: Cephalosporins and Fluoroquinolones are not good antibiotics using empirically as prophylactic measure for patients with hepatolithiasis in our setting. Imipenem, meropenem, doxycycline, amikacin, cefepime and Tazobactam/piperacillin can be used empirically in hepatolithiasis patients. However further study with larger sample size is recommended.