Short summary

Acute cholecystitis is an acute inflammatory disease of the gallbladder accounting for 3-10% of all patients with abdominal pain admitted to the hospital. The role of bacteria in the pathogenesis of early stages of acute cholecystitis is not clear. Bactibilia is defined as the colonization of bile by microorganisms. The presence of organisms in the bile does not necessarily correlate to an active infection. Not all organisms in the gallbladder are true pathogens.

Rationale

The aim of this project is to investigate the presence of bacteria in the gallbladder wall and the bile in patients undergoing cholecystectomy, to determine if the standard empirical antibiotic treatment used currently is effective against the most common pathogens. We will compare two groups of patients: patients with acute calculous cholecystitis undergoing acute laparoscopic cholecystectomy and patients without cholecystitis undergoing elective laparoscopic cholecystectomy. Secondly, to investigate if the grade of inflammation correlates with a positive culture as well as the duration of symptoms. In a clinical setting, this can provide important knowledge regarding the choice of antibiotics currently used to treat and prevent infection in the gallbladder.

Description of the cohort

We will investigate 2 groups of patients. All patients will undergo laparoscopic cholecystectomy at the Department of Surgery, Lillebælt Hospital, Kolding. The casegroup will be patients with acute cholecystitis, and the controlgroup will be patients undergoing laparoscopic cholecystectomy for reasons other than acute cholecystitis.

Data and biological material

We will take samples of bile and punch biopsies from the gallbladderwall from all included patients. They will be sent to the department of microbiology, Lillebælt Hospital, Vejle. The gallbladder will after surgery be sent to the Department of Pathology, Lillebælt Hospital, Vejle for examination and evaluation of the severity of inflammation.

Collaborating researchers and departments

Department of Pathology, Lillebælt Hospital, Vejle.

• Jan Lindebjerg

Department of Microbiology, Lillebælt Hospital, Vejle

• Stine Yde Nielsen
• Claus Østergaard