Gallbladder Drainage- Which to Culture - First or Last ?

M Kak 1,2 R. Nir-paz 2 N. Goldberg S 1 Liat Appelbaum 1
1Department of Radiology, Hadassah Hebrew University Medical Center,, Israel
2Department of Microbiology, Hadassah Hebrew University Medical Center,, Israel

PURPOSE: There is a visual difference both in color and in texture between the first sample taken after cholecystostom insertion and the last- after most of the content has been actively drained. Our purpose was to determine the clinical difference between them according to the microbiology result, and which of them should be cultured.

MATERIALS AND METHODS: Our search included 70 patients between 2013-2018 who were treated with imaging guided gallbladder drainage (US or CT), the first sample after placing the drain was sent separated from the last sample after emptying the gallbladder and the results of the cultures were analyzed to determine the difference between there if there is any.

RESULT: Overall, 49 patients (70%) were with different results between the two samples- the bacterial titer was much higher in the second sample, leading to a quicker microbiology result. 5 patients 7% were with new additional bacteria in the second dose.

CONCLUSION: It seems to be more accurate to empty the gallbladder and then take the culture because the higher concentration of the bacteria will enable a faster microbiology result.