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ID 21467
file
creator
Uemura, Kenichiro
Hayashidani, Yasuo
NDC
Medical sciences
abstract
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.
journal title
World Journal of Surgery
volume
Volume 31
issue
Issue 11
start page
2230
end page
2235
date of issued
2007-11
publisher
Springer
issn
0364-2313
ncid
publisher doi
language
eng
nii type
Journal Article
HU type
Journal Articles
DCMI type
text
format
application/pdf
text version
author
rights
Copyright(c) 2007 Springer
relation
The original publication is available at www.springerlink.com
relation is version of URL
http://dx.doi.org/10.1007/s00268-007-9210-4
department
Graduate School of Biomedical Science