The microbiological impact of pre-operative biliary drainage on patients undergoing hepato-biliary-pancreatic (HPB) surgery

Autor:	P. Jethwa, E. Breuning, Darius F. Mirza, Simon R. Bramhall, J. Buckles, Chandra Bhati
Rok vydání:	2007
Předmět:	medicine.medical_specialty Percutaneous Endoscopic retrograde cholangiopancreatography Hepatology medicine.diagnostic_test business.industry medicine.medical_treatment Gastroenterology medicine.disease Percutaneous transhepatic cholangiography Surgery Sepsis medicine.anatomical_structure Biliary tract Internal medicine Medicine Sputum Pharmacology (medical) Antibiotic prophylaxis medicine.symptom business Pancreas
Zdroj:	Alimentary Pharmacology & Therapeutics. 25:1175-1180
ISSN:	1365-2036 0269-2813
DOI:	10.1111/j.1365-2036.2007.03289.x
Popis:	SUMMARY Background The merit of pre-operative biliary drainage in managing hepatic, biliary or pancreatic patients remains unclear with previous studies demonstrating significant increases in bacterobilia. Aims To establish if pre-operative biliary drainage was associated with (i) a change in bacterial flora, (ii) post-operative sepsis and (iii) to ascertain if a modification of antibiotic prophylaxis was warranted. Methods Data were collected on 331 patients undergoing hepatic, biliary or pancreatic surgery for malignant obstruction between August 2000 and June 2005. Microbiological data from intra-operative bile, post-operative wounds, blood cultures, urine and sputum were analysed. All episodes of pre-operative endoscopic retrograde cholangiopancreatography (ERCP), stenting and percutaneous drainage were documented. Results One hundred and sixty two patients had ERCP prior to surgery and 154 had surgery only. In comparison to patients who had surgery alone stented patients had significantly increased rates of bacterobilia (40 vs. 85%) and fungobilia (8 vs. 34%, both P
Databáze:	OpenAIRE
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