2025 Volume 45 Issue 7 Pages 587-593
Background: Although intraoperative bile culture is frequently performed during emergency laparoscopic cholecystectomy (LC) for acute cholecystitis, its clinical significance remains unclear; this study was aimed at evaluating its clinical relevance and limitations. Methods: We retrospectively analyzed the data of 136 patients who had undergone emergency LC for acute cholecystitis between January 2014 and December 2023. We compared the clinical and perioperative factors in relation to the results of bile culture. Results: The bile cultures were positive in 49.3％ of the cases. Bile culture positivity was associated with older age, higher ASA physical status grade, and elevated postoperative serum CRP levels. It was also associated with prolonged antibiotic treatment and extended postoperative hospital stays. However, no significant association was found between bile culture positivity and cholecystitis-specific factors, such as the severity of cholecystitis or time from symptom onset. Importantly, the culture results did not lead to any changes in the antibiotic regimens used. Conclusions: Bile culture positivity was associated with delayed postoperative healing and with older age and higher ASA-PS grade. However, due to the time required to obtain the results of culture, its utility in immediate clinical decision-making is limited. Further evaluation is needed to determine its role in perioperative management.
