An observational study in Calculous Cholecystitis, Antibiotic Resistant Infection and Gallbladder Inflammation, sponsored by Organkirurgisk afdeling, sygehus lillebælt, Kolding. Status unknown at 1 site in Denmark. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2024-04-15.
Sponsored by Organkirurgisk afdeling, sygehus lillebælt, Kolding · Observational
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.
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.
272 studies on the registry are indexed under Cholecystitis; 46 are open to participants now.
This study's planned enrollment of 60 is below the median of 200 across 91 observational studies indexed under Cholecystitis.
Browse Cholecystitis studies →This is the only study on the registry with Organkirurgisk afdeling, sygehus lillebælt, Kolding as lead sponsor.
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The following data will be collected for all included patients:
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Exclusion Criteria:
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.
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
Other: Microbiological and histopathological investigation of bile and gallbladder wall specimens.
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
Other: 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.
Bacterial colonization in bile and gallbladder wall samples
Microbiological investigation of microorganisms present in the bile and in the gallbladder wall. Bile samples will be collected by puncturing the gallbladder either perioperatively or immediate after extraction of the gallbladder from the abdomen. This is done in a sterile manner using a syringe. The gallbladder wall specimens are collected immediately after extraction of the gallbladder from the abdomen. Three samples will be taken from macroscopic normal looking parts of the posterior wall in the fundus area using a sterile 4 mm punch biopsy. Bile samples and punch biopsies sent to the Department of Clinical Microbiology, SLB, will be cultured on selected agar growth media and incubated under aerobic, microaerophilic, and anaerobic conditions. Bacterial colonies will be identified and quantified using routine laboratory methods.
Time frame: 36-72 hours
Antibiotic resistans
Microbiological investigation of antibiotic resistans of the bacteria, if any, present in bile and gallbladder wall specimens. Antimicrobial susceptibility testing will be performed using the disk diffusion method. To determine the possible presence of inhibitory concentrations of antibiotics in the bile samples, a droplet of bile from each sample will be added to an agar plate inoculated with the E. coli ATCC 25922-strain. After incubation, the appearance of a growth inhibition zone will be measured.
Time frame: 36-72 hours
Histopathology of the gallbladder
Histopathological investigation of the gallbladder to investigate if there is either inflammation or an actual infection and correlate these findings to the bacterial colonization. The gallbladder from all included patients will be sent to the Department of Pathology, SLB, for evaluation of the grade of inflammation. After formalin fixation sections from the cystic duct, the corpus and the fundus area will be sampled. The sections will be embedded in paraffin and will be cut into thin slices, which will be dyed with hematoxylin and eosin. The grade of acute inflammation will be assessed in a semi quantitative manner: Grade 1: superficial ulceration of the mucosa concomitant with light infiltration by neutrophile granulocytes Grade 2: infiltration by granulocytes, spreading into the deeper layers of the gallbladder wall. Grade 3: profound necrosis, extending through the entire gallbladder wall.
Time frame: 3-21 days
Plan to share: Undecided
Started Apr 2023 (actual). Primary completion is estimated for Jun 2025, 26 months after the start.
Of 34 non-industry observational studies under Cholecystitis, half reached primary completion within 22 months of starting (the median), counting those still running; a quarter within 11 and three quarters within 44. This study's planned 26 months is above that.
Counting every sponsor, half of 36 studies reached it within 22 months; a quarter within 11 and three quarters within 42.
How these figures are worked out, and which studies are left out of them.
This study is status unknown, as verified in Apr 2024. You cannot join it, but the record below documents what was studied.
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