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01-01-2021 | Pancreatoduodenostomy | Pancreatic Tumors

Impact of Qualitative and Quantitative Biliary Contamination Status on the Incidence of Postoperative Infection Complications in Patients Undergoing Pancreatoduodenectomy

Authors: Masaya Suenaga, MD, PhD, Yukihiro Yokoyama, MD, PhD, Tsutomu Fujii, MD, PhD, Suguru Yamada, MD, PhD, Junpei Yamaguchi, MD, PhD, Masamichi Hayashi, MD, PhD, Takashi Asahara, PhD, Masato Nagino, MD, PhD, Yasuhiro Kodera, MD, PhD

Published in: Annals of Surgical Oncology | Issue 1/2021

Abstract

Background

Bacterial contamination status may differ under different biliary drainage conditions. The purpose of this study was to determine the impact of qualitative and quantitative biliary bacterial contamination on the incidence of infection complications in patients undergoing pancreatoduodenectomy.

Methods

Patients undergoing pancreatoduodenectomy for periampullary diseases with different biliary drainage conditions, such as external drainage (ED), internal drainage (ID), and no drainage (ND), were included. Bile was collected intraoperatively, and biliary contamination status was qualified and quantified using bacterium-specific ribosomal RNA-targeted reverse transcription–quantitative polymerase chain reaction (RT-qPCR). The impact of biliary contamination status on infection complications was analyzed.

Results

A total of 152 patients were included (38 with ED, 40 with ID, and 74 with ND). The positive rate of microorganisms in bile was higher in the ID group (98%) compared with the ED group (82%, p = 0.021) and the ND group (65%, p < 0.001). The number of microorganisms detected in bile samples was higher in the ID group compared with the ED group (median 489,788 vs. 5375 bacteria/mL of bile, p < 0.001). With multivariate analysis, soft pancreas, intraoperative bleeding (> 600 mL), and biliary contamination by Atopobium cluster were identified as independent risk factors for infection complications. Biliary contamination by Atopobium cluster was significantly higher in the ID group compared with the other groups.

Conclusions

Biliary bacterial contamination is more frequently induced by ID than either ED or ND. In addition to the previously known risk factors, biliary contamination with Atopobium cluster may be one of the risk factors of infection complications following pancreatoduodenectomy.

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Title: Impact of Qualitative and Quantitative Biliary Contamination Status on the Incidence of Postoperative Infection Complications in Patients Undergoing Pancreatoduodenectomy
Authors: Masaya Suenaga, MD, PhD
Yukihiro Yokoyama, MD, PhD
Tsutomu Fujii, MD, PhD
Suguru Yamada, MD, PhD
Junpei Yamaguchi, MD, PhD
Masamichi Hayashi, MD, PhD
Takashi Asahara, PhD
Masato Nagino, MD, PhD
Yasuhiro Kodera, MD, PhD
Publication date: 01-01-2021
Publisher: Springer International Publishing
Keywords: Pancreatoduodenostomy
Clostridium
Pancreatoduodenostomy
Published in: Annals of Surgical Oncology / Issue 1/2021
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-020-08645-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Impact of Qualitative and Quantitative Biliary Contamination Status on the Incidence of Postoperative Infection Complications in Patients Undergoing Pancreatoduodenectomy

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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