Specific antibiotic prophylaxis based on bile cultures is required to prevent postoperative infectious complications in pancreatoduodenectomy patients who have undergone preoperative biliary drainage
World Journal of Surgery 31 巻 11 号
2230-2235 頁
2007-11 発行
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| ファイル情報(添付) | |
| タイトル ( eng ) |
Specific antibiotic prophylaxis based on bile cultures is required to prevent postoperative infectious complications in pancreatoduodenectomy patients who have undergone preoperative biliary drainage
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| 作成者 |
Uemura Kenichiro
Hayashidani Yasuo
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| 収録物名 |
World Journal of Surgery
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| 巻 | 31 |
| 号 | 11 |
| 開始ページ | 2230 |
| 終了ページ | 2235 |
| 抄録 |
Background Preoperative biliary drainage (PBD) is associated with bacterial contamination of bile, but the effects of PBD on morbidity after pancreatoduodenectomy remain controversial. The aim of this study was to characterize bile contamination to develop successful specific antibiotic prophylactic strategies for pancreatoduodenectomy. Methods Ninety-one consecutive patients who underwent pancreatoduodenectomy for periampullary tumor were prospectively evaluated. Prophylactic antibiotics were selected based on preoperative bile cultures. Bile cultures and postoperative complications were compared in 46 patients who underwent PBD (drainage group) versus 45 patients who did not (nondrainage group). Results The incidence of positive bile cultures was higher in the drainage group (78%) than in the nondrainage group (36%) (P < 0.001). In the drainage group, positive bile cultures were frequently polymicrobial (61%) and demonstrated resistance to several antibiotics, including cefazolin (83%), cefmetazole (72%), and cefpirome (64%). Overall morbidity (30-0x1.fd580000008p+0nd 22%) and infectious morbidity (13 0x1.f72676b636142p+855nd 11%) did not differ significantly between the drainage and nondrainage groups, respectively. Conclusions PBD had a notable influence on bile microbial contamination, including a higher rate of antibiotic resistance. Therefore, specific antibiotic prophylaxis based on bile culture is required for preventing infectious complications in pancreatoduodenectomy patients who undergo PBD.
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| NDC分類 |
医学 [ 490 ]
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| 言語 |
英語
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| 資源タイプ | 学術雑誌論文 |
| 出版者 |
Springer
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| 発行日 | 2007-11 |
| 権利情報 |
Copyright(c) 2007 Springer
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| 出版タイプ | Author’s Original（十分な品質であるとして、著者から正式な査読に提出される版） |
| アクセス権 | オープンアクセス |
| 収録物識別子 |
The original publication is available at www.springerlink.com
[ISSN] 0364-2313
[DOI] 10.1007/s00268-007-9210-4
[NCID] AA0089099X
[DOI] http://dx.doi.org/10.1007/s00268-007-9210-4
～の異版である
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