Antimicrobial susceptibility of biliary stents do not predict infectious complications after whipple
| Autor: | Mary Varsanik, Ruojia Li, Christian Renz, Lawrence M. Knab, Weston A. Terrasse, Gerard Abood, Marshall S. Baker, Nancy Pak, Caitlyn Ko, Jorge P. Parada, Madeline Gauthier, Caressa Chen, Emanuel Eguia |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Antimicrobial susceptibility Microbial Sensitivity Tests Tertiary care Pancreaticoduodenectomy Preoperative Care Humans Surgical Wound Infection Medicine In patient Biliary Tract Aged Retrospective Studies Intraoperative Care business.industry Stent Retrospective cohort study Perioperative Antibiotic Prophylaxis Middle Aged equipment and supplies Anti-Bacterial Agents Surgery Pancreatic Neoplasms Biliary Tract Surgical Procedures Treatment Outcome Drainage Biliary stent Female Stents business |
| Zdroj: | Surgery. 168:457-461 |
| ISSN: | 0039-6060 |
| DOI: | 10.1016/j.surg.2020.05.025 |
| Popis: | Background Postoperative infectious complications after a pancreaticoduodenectomy remain a significant cause of morbidity. Studies have demonstrated that a preoperative biliary stent increases the risk of postoperative infectious complications. Few studies have investigated the specific preoperative biliary stent bacterial sensitivities to preoperative antibiotics and the effect on infectious complications. The goal of this study was to investigate if the presence of a preoperative biliary stent increases the risk of postoperative infectious complications in patients undergoing a pancreaticoduodenectomy. Additionally, we aimed to investigate biliary stent culture sensitivities to preoperative antibiotics and determine if those sensitivities impacted postoperative infectious complications after a pancreaticoduodenectomy. Methods A retrospective chart review of patients who had undergone a pancreaticoduodenectomy at a single institution tertiary care center from 2007 to 2018 was performed. Perioperative variables including microbiology cultures from biliary stents were collected and analyzed. Results A total of 244 patients underwent a pancreaticoduodenectomy. A preoperative biliary stent was present in 45 (18%) patients. Infectious complications occurred in 25% of those patients with a preoperative biliary stent, and 19% of those without (P = .37). Of those patients with a stent that was cultured intraoperatively, 92% grew bacteria and 61% of those were resistant to the preoperative antibiotics administered. Of the patients with a preoperative biliary stent and bacteria resistant to the preoperative antibiotics, 17% developed a postoperative infectious complication, compared with 20% if the bacteria cultured was susceptible to the preoperative antibiotics (P = .64). Conclusion Infectious complications after pancreaticoduodenectomy are a significant cause of morbidity. Stent bacterial sensitivities to preoperative antibiotics did not reduce the postoperative infectious complications in the preoperative biliary stent group suggesting a multifactorial cause of infections. |
| Databáze: | OpenAIRE |
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