Background: Bacterobilia is associated with postoperative morbidity after pancreaticoduodenectomy (PD), mostly due to infectious complications. The aim of this study was to investigate theprevalence of bacteria species isolated from intraoperative biliary cultures, and related complicationsafter PD. Methods: An ANOVA test was used to assess the prevalence of isolated bacterial speciesand postoperative complications. The odds ratio was computed to evaluate the association betweenbiliary cultures and each complication, Endoscopic Retrograde CholangioPancreatography (ERCP)and each complication, ERCP and biliary cultures, Delayed Gastric Emptying (DGE) and Postoperative Pancreatic Fistula (POPF). Results: Positive biliary cultures were found in 162/244 (66%)PDs. Different prevalences of polymicrobial biliary culture were detected in patients with postoperative complications. In SSIs, a significant prevalence of biliary culture positive for E. coli, Klebsiellapneumoniæ and Enterococcus fæcalis (p < 0.001) was detected. Prevalences of polymicrobial biliarycultures with Escherichia coli, Klebsiella pneumoniæ, Enterococcus fæcalis and Enterococcus fæcium weresignificantly associated with POPF (p < 0.001). Biliary culture positive for Escherichia coli, Enterococcusfæcalis and Enterococcus fæcium showed a higher prevalence of intra-abdominal collection and DGE(p < 0.001). Notably, Escherichia coli was significantly associated with DGE as a unique complication(OR = 2.94 (1.30–6.70); p < 0.01). Conclusions: Specific prevalences of polymicrobial bacterobilia areassociated with major complications, while monomicrobial Escherichia coli bacterobilia is associatedwith DGE as a unique complication after PD.
Different biliary microbial flora influence type of complications after pancreaticoduodenectomy: a single center retrospective analysis
Fiore M;Ramella S;Spoto S;Ciccozzi M;Angeletti S;Coppola R;Caputo D
2021-01-01
Abstract
Background: Bacterobilia is associated with postoperative morbidity after pancreaticoduodenectomy (PD), mostly due to infectious complications. The aim of this study was to investigate theprevalence of bacteria species isolated from intraoperative biliary cultures, and related complicationsafter PD. Methods: An ANOVA test was used to assess the prevalence of isolated bacterial speciesand postoperative complications. The odds ratio was computed to evaluate the association betweenbiliary cultures and each complication, Endoscopic Retrograde CholangioPancreatography (ERCP)and each complication, ERCP and biliary cultures, Delayed Gastric Emptying (DGE) and Postoperative Pancreatic Fistula (POPF). Results: Positive biliary cultures were found in 162/244 (66%)PDs. Different prevalences of polymicrobial biliary culture were detected in patients with postoperative complications. In SSIs, a significant prevalence of biliary culture positive for E. coli, Klebsiellapneumoniæ and Enterococcus fæcalis (p < 0.001) was detected. Prevalences of polymicrobial biliarycultures with Escherichia coli, Klebsiella pneumoniæ, Enterococcus fæcalis and Enterococcus fæcium weresignificantly associated with POPF (p < 0.001). Biliary culture positive for Escherichia coli, Enterococcusfæcalis and Enterococcus fæcium showed a higher prevalence of intra-abdominal collection and DGE(p < 0.001). Notably, Escherichia coli was significantly associated with DGE as a unique complication(OR = 2.94 (1.30–6.70); p < 0.01). Conclusions: Specific prevalences of polymicrobial bacterobilia areassociated with major complications, while monomicrobial Escherichia coli bacterobilia is associatedwith DGE as a unique complication after PD.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
