Cholecystitis From a Microbiological and Histopathological Perspective

NCT ID: NCT05712733

Last Updated: 2024-04-15

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Total Enrollment

60 participants

Study Classification

OBSERVATIONAL

Study Start Date

2023-04-01

Study Completion Date

2025-10-31

Brief Summary

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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.

Detailed Description

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The investigators will compare two groups of patients; patients with acute calculous cholecystitis undergoing acute laparoscopic cholecystectomy and patients without cholecystitis undergoing elective laparoscopic cholecystectomy.

Secondly, the investigators wish to investigate if the presence of bacteria correlates with the grade of inflammation, and whether this can predict when cholecystitis is caused by infection.

In a clinical setting, this can provide important knowledge regarding the choice of antibiotics currently used to treat and prevent infection in the gallbladder.

The investigators will conduct two studies, one investigating the bacteria in bile and in the gallbladder wall and the resistens of the bacteria to antibiotics and another study investigating the histopathology of the gallbladder wall to see if the bacteria present is the cause of inflammation or an actual infection.

Conditions

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Calculous Cholecystitis Antibiotic Resistant Infection Gallbladder Inflammation

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

PROSPECTIVE

Study Groups

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Case group

Patients suffering from acute calculous cholecystitis undergoing subacute laparoscopic cholecystectomy.

Samples of bile and gallbladder wall specimens will be taken during surgery and will be sent for microbiological and pathological investigation

Microbiological and histopathological investigation of bile and gallbladder wall specimens.

Intervention Type OTHER

Bile and gallbladder wall specimens will be taken from all patients included in the study. The material will be sent for microbiological and histopathological investigation.

Control group

Patients suffering from painattacks due to gallstones, who have not symptoms of cholecystitis. The patients will undergo elective laparoscopic cholecystectomy.

Samples of bile and gallbladder wall specimens will be taken during surgery and will be sent for microbiological and pathological investigation

Microbiological and histopathological investigation of bile and gallbladder wall specimens.

Intervention Type OTHER

Bile and gallbladder wall specimens will be taken from all patients included in the study. The material will be sent for microbiological and histopathological investigation.

Interventions

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Microbiological and histopathological investigation of bile and gallbladder wall specimens.

Bile and gallbladder wall specimens will be taken from all patients included in the study. The material will be sent for microbiological and histopathological investigation.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Age above 18 years
* Signed consent form
* Patients having cholecystectomy performed at the Department of Surgery, Sygehus Lillebælt, Kolding.

Exclusion Criteria

* Administration of any type of antibiotics one month prior to surgery in the control group.
* Previous instrumentation of the bileducts
* Previous clinical acute cholecystitis treated conservatively with antibiotics

Patients will be precluded from the studypopulation in cases of pPerioperative perforation of the gallbladder, or conversion to open cholecystectomy or in cases of failed attempts to extract bile or samples from the gallbladder wall.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Organkirurgisk afdeling, sygehus lillebælt, Kolding

NETWORK

Sponsor Role lead

Responsible Party

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Malene Borgager Dissing

Malene Børgager Dissing, MD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Malene B Dissing, MD

Role: PRINCIPAL_INVESTIGATOR

Organkirurgisk afdeling, sygehus lillebælt, Kolding

Locations

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Sygehus Lillebælt

Kolding, , Denmark

Site Status RECRUITING

Countries

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Denmark

Central Contacts

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Malene B Dissing, MD

Role: CONTACT

004528745840

Louise L Pontoppidan, MD

Role: CONTACT

004527124689

Facility Contacts

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Malene Børgager Dissing

Role: primary

References

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Kimura Y, Takada T, Kawarada Y, Nimura Y, Hirata K, Sekimoto M, Yoshida M, Mayumi T, Wada K, Miura F, Yasuda H, Yamashita Y, Nagino M, Hirota M, Tanaka A, Tsuyuguchi T, Strasberg SM, Gadacz TR. Definitions, pathophysiology, and epidemiology of acute cholangitis and cholecystitis: Tokyo Guidelines. J Hepatobiliary Pancreat Surg. 2007;14(1):15-26. doi: 10.1007/s00534-006-1152-y. Epub 2007 Jan 30.

Reference Type BACKGROUND
PMID: 17252293 (View on PubMed)

Indar AA, Beckingham IJ. Acute cholecystitis. BMJ. 2002 Sep 21;325(7365):639-43. doi: 10.1136/bmj.325.7365.639. No abstract available.

Reference Type BACKGROUND
PMID: 12242178 (View on PubMed)

Halpin V. Acute cholecystitis. BMJ Clin Evid. 2014 Aug 20;2014:0411.

Reference Type BACKGROUND
PMID: 25144428 (View on PubMed)

Lou MA, Mandal AK, Alexander JL, Thadepalli H. Bacteriology of the human biliary tract and the duodenum. Arch Surg. 1977 Aug;112(8):965-7. doi: 10.1001/archsurg.1977.01370080063010.

Reference Type BACKGROUND
PMID: 195558 (View on PubMed)

Fukunaga FH. Gallbladder bacteriology, histology, and gallstones. Study of unselected cholecystectomy specimens in Honolulu. Arch Surg. 1973 Feb;106(2):169-71. doi: 10.1001/archsurg.1973.01350140033011. No abstract available.

Reference Type BACKGROUND
PMID: 4346851 (View on PubMed)

Sianesi M, Berri T. [Bacteriological studies on the bile in different conditions of surgical interest]. Chir Ital. 1976 Aug;28(4):341-55. Italian.

Reference Type BACKGROUND
PMID: 1009648 (View on PubMed)

Brody LA, Brown KT, Getrajdman GI, Kannegieter LS, Brown AE, Fong Y, Blumgart LH. Clinical factors associated with positive bile cultures during primary percutaneous biliary drainage. J Vasc Interv Radiol. 1998 Jul-Aug;9(4):572-8. doi: 10.1016/s1051-0443(98)70324-0.

Reference Type BACKGROUND
PMID: 9684825 (View on PubMed)

Siegman-Igra Y, Schwartz D, Konforti N, Perluk C, Rozin RR. Septicemia from biliary tract infection. Arch Surg. 1988 Mar;123(3):366-8. doi: 10.1001/archsurg.1988.01400270106016.

Reference Type BACKGROUND
PMID: 3341915 (View on PubMed)

Park JW, Lee JK, Lee KT, Lee KH, Sung YK, Kang CI. How to interpret the bile culture results of patients with biliary tract infections. Clin Res Hepatol Gastroenterol. 2014 Jun;38(3):300-9. doi: 10.1016/j.clinre.2014.02.005. Epub 2014 Mar 24.

Reference Type BACKGROUND
PMID: 24674840 (View on PubMed)

Rupp C, Bode K, Weiss KH, Rudolph G, Bergemann J, Kloeters-Plachky P, Chahoud F, Stremmel W, Gotthardt DN, Sauer P. Microbiological Assessment of Bile and Corresponding Antibiotic Treatment: A Strobe-Compliant Observational Study of 1401 Endoscopic Retrograde Cholangiographies. Medicine (Baltimore). 2016 Mar;95(10):e2390. doi: 10.1097/MD.0000000000002390.

Reference Type BACKGROUND
PMID: 26962768 (View on PubMed)

Suh SW, Choi YS, Choi SH, Do JH, Oh HC, Kim HJ, Lee SE. Antibiotic selection based on microbiology and resistance profiles of bile from gallbladder of patients with acute cholecystitis. Sci Rep. 2021 Feb 3;11(1):2969. doi: 10.1038/s41598-021-82603-8.

Reference Type BACKGROUND
PMID: 33536564 (View on PubMed)

Capoor MR, Nair D, Rajni, Khanna G, Krishna SV, Chintamani MS, Aggarwal P. Microflora of bile aspirates in patients with acute cholecystitis with or without cholelithiasis: a tropical experience. Braz J Infect Dis. 2008 Jun;12(3):222-5. doi: 10.1590/s1413-86702008000300012.

Reference Type BACKGROUND
PMID: 18839486 (View on PubMed)

Gipson KS, Nickerson KP, Drenkard E, Llanos-Chea A, Dogiparthi SK, Lanter BB, Hibbler RM, Yonker LM, Hurley BP, Faherty CS. The Great ESKAPE: Exploring the Crossroads of Bile and Antibiotic Resistance in Bacterial Pathogens. Infect Immun. 2020 Sep 18;88(10):e00865-19. doi: 10.1128/IAI.00865-19. Print 2020 Sep 18.

Reference Type BACKGROUND
PMID: 32661122 (View on PubMed)

Kwon W, Jang JY, Kim EC, Park JW, Han IW, Kang MJ, Kim SW. Changing trend in bile microbiology and antibiotic susceptibilities: over 12 years of experience. Infection. 2013 Feb;41(1):93-102. doi: 10.1007/s15010-012-0358-y. Epub 2012 Nov 21.

Reference Type BACKGROUND
PMID: 23180506 (View on PubMed)

Begley M, Gahan CG, Hill C. The interaction between bacteria and bile. FEMS Microbiol Rev. 2005 Sep;29(4):625-51. doi: 10.1016/j.femsre.2004.09.003.

Reference Type BACKGROUND
PMID: 16102595 (View on PubMed)

Ganzle MG, Hertel C, van der Vossen JM, Hammes WP. Effect of bacteriocin-producing lactobacilli on the survival of Escherichia coli and Listeria in a dynamic model of the stomach and the small intestine. Int J Food Microbiol. 1999 Apr 1;48(1):21-35. doi: 10.1016/s0168-1605(99)00025-2.

Reference Type BACKGROUND
PMID: 10375132 (View on PubMed)

Maseda E, Maggi G, Gomez-Gil R, Ruiz G, Madero R, Garcia-Perea A, Aguilar L, Gilsanz F, Rodriguez-Bano J. Prevalence of and risk factors for biliary carriage of bacteria showing worrisome and unexpected resistance traits. J Clin Microbiol. 2013 Feb;51(2):518-21. doi: 10.1128/JCM.02469-12. Epub 2012 Nov 28.

Reference Type BACKGROUND
PMID: 23196362 (View on PubMed)

Fisher K, Phillips C. The ecology, epidemiology and virulence of Enterococcus. Microbiology (Reading). 2009 Jun;155(Pt 6):1749-1757. doi: 10.1099/mic.0.026385-0. Epub 2009 Apr 21.

Reference Type BACKGROUND
PMID: 19383684 (View on PubMed)

Arnold RS, Thom KA, Sharma S, Phillips M, Kristie Johnson J, Morgan DJ. Emergence of Klebsiella pneumoniae carbapenemase-producing bacteria. South Med J. 2011 Jan;104(1):40-5. doi: 10.1097/SMJ.0b013e3181fd7d5a.

Reference Type BACKGROUND
PMID: 21119555 (View on PubMed)

van Dijk AH, de Reuver PR, Tasma TN, van Dieren S, Hugh TJ, Boermeester MA. Systematic review of antibiotic treatment for acute calculous cholecystitis. Br J Surg. 2016 Jun;103(7):797-811. doi: 10.1002/bjs.10146. Epub 2016 Mar 30.

Reference Type BACKGROUND
PMID: 27027851 (View on PubMed)

Galili O, Eldar S Jr, Matter I, Madi H, Brodsky A, Galis I, Eldar S Sr. The effect of bactibilia on the course and outcome of laparoscopic cholecystectomy. Eur J Clin Microbiol Infect Dis. 2008 Sep;27(9):797-803. doi: 10.1007/s10096-008-0504-8. Epub 2008 Mar 28.

Reference Type BACKGROUND
PMID: 18369670 (View on PubMed)

Grande M, Torquati A, Farinon AM. Wound infection after cholecystectomy. Correlation between bacteria in bile and wound infection after operation on the gallbladder for acute and chronic gallstone disease. Eur J Surg. 1992 Feb;158(2):109-12.

Reference Type BACKGROUND
PMID: 1350211 (View on PubMed)

Adachi T, Eguchi S, Muto Y. Pathophysiology and pathology of acute cholecystitis: A secondary publication of the Japanese version from 1992. J Hepatobiliary Pancreat Sci. 2022 Feb;29(2):212-216. doi: 10.1002/jhbp.912. Epub 2021 Mar 27.

Reference Type BACKGROUND
PMID: 33570821 (View on PubMed)

Panni RZ, Chatterjee D, Panni UY, Robbins KJ, Liu J, Strasberg SM. Sequential histologic evolution of gallbladder inflammation in acute cholecystitis over the first 10 days after onset of symptoms. J Hepatobiliary Pancreat Sci. 2023 Jun;30(6):724-736. doi: 10.1002/jhbp.1274. Epub 2022 Dec 1.

Reference Type BACKGROUND
PMID: 36399043 (View on PubMed)

Mazeh H, Mizrahi I, Dior U, Simanovsky N, Shapiro M, Freund HR, Eid A. Role of antibiotic therapy in mild acute calculus cholecystitis: a prospective randomized controlled trial. World J Surg. 2012 Aug;36(8):1750-9. doi: 10.1007/s00268-012-1572-6.

Reference Type BACKGROUND
PMID: 22456803 (View on PubMed)

Coccolini F, Sartelli M, Catena F, Montori G, Di Saverio S, Sugrue M, Ceresoli M, Manfredi R, Ansaloni L; CIAO and CIAOW Study Groups. Antibiotic resistance pattern and clinical outcomes in acute cholecystitis: 567 consecutive worldwide patients in a prospective cohort study. Int J Surg. 2015 Sep;21:32-7. doi: 10.1016/j.ijsu.2015.07.013. Epub 2015 Jul 17.

Reference Type BACKGROUND
PMID: 26192973 (View on PubMed)

Jimenez E, Sanchez B, Farina A, Margolles A, Rodriguez JM. Characterization of the bile and gall bladder microbiota of healthy pigs. Microbiologyopen. 2014 Dec;3(6):937-49. doi: 10.1002/mbo3.218. Epub 2014 Oct 21.

Reference Type BACKGROUND
PMID: 25336405 (View on PubMed)

Antimicrobial Resistance Collaborators. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. Lancet. 2022 Feb 12;399(10325):629-655. doi: 10.1016/S0140-6736(21)02724-0. Epub 2022 Jan 19.

Reference Type BACKGROUND
PMID: 35065702 (View on PubMed)

Other Identifiers

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MBDissing

Identifier Type: -

Identifier Source: org_study_id

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