The association between bacterobilia and the risk of postoperative complications following pancreaticoduodenectomy
| Autor: | Allison Mah, Jennifer Li, Sameer Desai, Maja Segedi, Stephen W Chung, Marina L Parapini, Charles H. Scudamore, Elizaveta Vasilyeva, James R. A. Skipworth, Peter T Kim |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
medicine.drug_class medicine.medical_treatment Antibiotics Gastroenterology Pancreaticoduodenectomy Bacterial colonization Pancreatectomy Postoperative Complications Internal medicine Preoperative Care Medicine Bile Humans Surgical Wound Infection Major complication Risk factor Retrospective Studies Hepatology business.industry Incidence (epidemiology) Retrospective cohort study Cohort business |
| Zdroj: | HPB : the official journal of the International Hepato Pancreato Biliary Association. 24(2) |
| ISSN: | 1477-2574 |
| Popis: | Background Pre-operative biliary bacterial colonisation (bacterobilia) is considered a risk factor for infectious complications after pancreaticoduodenectomy (PD). This study aimed to investigate the role of the PD biliary microbiome grown in the development of post-PD complications. Methods In a retrospective study of 162 consecutive patients undergoing PD (2008–2018), intra-operative bile cultures were analyzed and sensitivities compared to pre-anesthetic antibiotics and thirty-day post-surgery complications. Results Bacterobilia was present in 136 patients (84%). Most bile cultures grew bacteria resistant to pre-operative antibiotics (n = 112, 82%). Patients with bacterobilia had significantly higher rates of major complication than patients without (P = 0.017), as well as higher rates of surgical-site infections (SSI) (P = 0.010). Patients with negative bile cultures (n = 26) had significantly lower rates of major complication and SSI than those growing sensitive (n = 24) or non-sensitive (n = 112) bacteria (major complication P = 0.029 and SSI P = 0.011). Conclusion Positive bile cultures were associated with a higher incidence of major complications and SSI. Patients with sterile bile cultures had the lowest risk of post-operative complications and efforts to reduce rates of bacterobilia, such as limitation of biliary instrumentation, should be considered. Sensitivity to antibiotics had no effect upon the rate of post-operative complications, but this may reflect low cohort numbers. |
| Databáze: | OpenAIRE |
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