Drain Contamination after Distal Pancreatectomy: Incidence, Risk Factors, and Association with Postoperative Pancreatic Fistula
| Autor: | Sijie Hao, Chen Jin, Feng Yang, Deliang Fu |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Databases Factual macromolecular substances 030230 surgery Gastroenterology Body Mass Index Pancreatic Fistula Young Adult 03 medical and health sciences Pancreatectomy Postoperative Complications 0302 clinical medicine Risk Factors Internal medicine medicine Humans Clinical significance Risk factor Aged Retrospective Studies business.industry Incidence Mortality rate Incidence (epidemiology) Postoperative complication hemic and immune systems Middle Aged medicine.disease Pancreatic fistula 030220 oncology & carcinogenesis Drainage Female Surgery Distal pancreatectomy business Body mass index |
| Zdroj: | Journal of Gastrointestinal Surgery. 23:2449-2458 |
| ISSN: | 1873-4626 1091-255X |
| Popis: | Distal pancreatectomy (DP) remains associated with significant morbidity, but little data is available about the clinical significance of drain contamination. We explored the incidence, risk factors, and association with surgical outcomes of positive drainage culture (PDC) after DP. In addition, the predictive capacity of early PDC for postoperative pancreatic fistula (POPF) was evaluated. We retrospectively analyzed our prospectively collected database of patients who underwent DP between January 2005 and December 2015. Surveillance drainage cultures for microorganisms were conducted until drain removal or positive culture. The relationships between clinical variables and PDC were examined. Of 480 consecutive cases who underwent DP, 176 (36.7%) had PDC. One hundred twelve patients (23.3%) developed POPF according to the 2016 ISGPS definition, with the 90-day mortality rate of 0.2%. Staphylococcus spp. was the most frequent isolate. Thirty-eight (21.6%) patients had PDC within 3 days after surgery, and 129 (73.3%) within the first 7 days of operation. Body mass index (BMI) ≥ 25 kg/m2 and massive intraoperative blood loss were independent predictors for PDC. PDC had a negative impact on surgical outcomes, including POPF. Early PDC was identified as a newly independent risk factor for POPF. Compared with other microorganisms, those contaminated with Staphylococcus and Klebsiella had higher incidences of POPF. PDC occurs commonly after DP and plays a critical role in the development of surgical morbidities including POPF. Extreme caution is warranted in patients involving contamination with specific types of microorganisms. |
| Databáze: | OpenAIRE |
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