New insight into the association between bile infection and clinically relevant pancreatic fistula in patients undergoing pancreatoduodenectomy

Background The association between bacterial infection and clinically relevant postoperative pancreatic fistula (CR‐POPF) after pancreatoduodenectomy (PD) has not been fully elucidated. Methods Microbiological data for intraoperative bile culture (BC) and drain culture on postoperative day 4 (DC) we...

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Bibliographic Details
Published in:Journal of hepato-biliary-pancreatic sciences 2020-12, Vol.27 (12), p.992-1001
Main Authors: Nakamura, Kota, Sho, Masayuki, Kinoshita, Shoichi, Akahori, Takahiro, Nagai, Minako, Nakagawa, Kenji, Takagi, Tadataka, Ikeda, Naoya
Format: Article
Language:English
Subjects:
Bile
Enterococcus faecalis
Fistula
intraoperative bile sampling
pancreatic fistula
Pancreaticoduodenectomy
pancreatoduodenectomy
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Summary:Background The association between bacterial infection and clinically relevant postoperative pancreatic fistula (CR‐POPF) after pancreatoduodenectomy (PD) has not been fully elucidated. Methods Microbiological data for intraoperative bile culture (BC) and drain culture on postoperative day 4 (DC) were collected. The study population was classified into the following three groups: P1 (positive BC and DC), P2 (positive BC and negative DC), and N (negative BC). A total of 209 patients (P1: 38, P2: 72, and N: 99) who underwent PD between May 2013 and May 2018 met the inclusion criteria of the study. Results The rate of CR‐POPF was significantly higher in the P1 group (34.2%) than in the P2 (12.5%; P = .007) and N groups (14.1%; P = .008). Between P1 and P2 groups, a significant difference was observed in the proportion of Enterococcus faecalis grown in BC (42.1% vs 4.2%; P 
ISSN:1868-6974
1868-6982
DOI:10.1002/jhbp.781