Patterns, Predictors, and Outcomes of Bacterial Growth and Infectious Complications after Pancreatic Resection
Year: 2024
Type: article
Study design: Observational Study
Abstract: BACKGROUND AND OBJECTIVES: Infectious complications after pancreatic resections are common, but perioperative factors linked to postoperative bacterial growth are not well-studied. METHODS: This retrospective study analyzed bacterial cultures from patients undergoing pancreatic resection (November 2008 to October 2022), assessing predictors for positive cultures and characterizing bacteria. Complications and outcomes of patients with positive cultures were also examined. RESULTS: Among 620 patients, bile samples were collected in 95 (95/620; 15.3%), with 60 (60/95; 63.1%) testing positive, 58 of them underwent pancreaticoduodenectomy. Of these, in 50 (50/58; 86.2%) the culture yielded polymicrobial growth but specific types of bacteria were not identified. Multivariate analysis identified preoperative bile duct stenting as a significant predictor of positive bile cultures (OR: 3.54; 95% CI: 1.95-6.42; p < 0.001), and positive cultures were linked to higher reoperation rates (OR: 2.40; 95% CI:1.18-4.90; p < 0.001. Positive drain cultures within 30 days from surgery were associated with higher rates of clinically significant pancreatic fistula (OR: 2.24; 95% CI: 1.00-5.11; p = 0.05), and reoperations) OR: 4.37; 95% CI: 1.62-11.79; p = 0.03). Patients with pancreatic adenocarcinoma and positive bile cultures had shorter disease-free survival with a median of 13 months (95% CI: 8-17) versus 18 months (95% CI: 8-29; p = 0.04). CONCLUSIONS: Bile sampling is recommended in all pancreaticoduodenectomies. Managing polymicrobial growth with broad and prolonged antibiotics may reduce postoperative infections.
Source: Journal of Surgical Oncology
DOI: 10.1002/jso.27998
Institutions: Tel Aviv University, Sheba Medical Center
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4405336976