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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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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cited_by cdi_FETCH-LOGICAL-c3731-9cc9dedc89cb545dc5e12474897d5711b2b040babfc7fd4d6e55d42dbf41eff13
cites cdi_FETCH-LOGICAL-c3731-9cc9dedc89cb545dc5e12474897d5711b2b040babfc7fd4d6e55d42dbf41eff13
container_end_page 1001
container_issue 12
container_start_page 992
container_title Journal of hepato-biliary-pancreatic sciences
container_volume 27
creator Nakamura, Kota
Sho, Masayuki
Kinoshita, Shoichi
Akahori, Takahiro
Nagai, Minako
Nakagawa, Kenji
Takagi, Tadataka
Ikeda, Naoya
description 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 
doi_str_mv 10.1002/jhbp.781
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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 &lt; .001). Multivariable logistic regression analysis showed that the presence of E faecalis in bile was independently associated with CR‐POPF. Conclusions The detection of both bile and postoperative abdominal fluid infections can be more accurate in predicting CR‐POPF. Furthermore, the presence of E faecalis in bile may serve as a novel surrogate marker for CR‐POPF. Nakamura and colleagues showed that the detection of both bile infection and postoperative abdominal fluid infection may more accurately predict the development of clinically relevant postoperative pancreatic fistula after pancreatoduodenectomy. The presence of Enterococcus faecalis in bile may serve as a novel surrogate marker for clinically relevant postoperative pancreatic fistula.</description><identifier>ISSN: 1868-6974</identifier><identifier>EISSN: 1868-6982</identifier><identifier>DOI: 10.1002/jhbp.781</identifier><identifier>PMID: 32506812</identifier><language>eng</language><publisher>Japan: Wiley Subscription Services, Inc</publisher><subject>Bile ; Enterococcus faecalis ; Fistula ; intraoperative bile sampling ; pancreatic fistula ; Pancreaticoduodenectomy ; pancreatoduodenectomy</subject><ispartof>Journal of hepato-biliary-pancreatic sciences, 2020-12, Vol.27 (12), p.992-1001</ispartof><rights>2020 Japanese Society of Hepato‐Biliary‐Pancreatic Surgery</rights><rights>2020 Japanese Society of Hepato-Biliary-Pancreatic Surgery.</rights><rights>Copyright © 2020 Japanese Society of Hepato‐Biliary‐Pancreatic Surgery</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3731-9cc9dedc89cb545dc5e12474897d5711b2b040babfc7fd4d6e55d42dbf41eff13</citedby><cites>FETCH-LOGICAL-c3731-9cc9dedc89cb545dc5e12474897d5711b2b040babfc7fd4d6e55d42dbf41eff13</cites><orcidid>0000-0002-6208-7661</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32506812$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nakamura, Kota</creatorcontrib><creatorcontrib>Sho, Masayuki</creatorcontrib><creatorcontrib>Kinoshita, Shoichi</creatorcontrib><creatorcontrib>Akahori, Takahiro</creatorcontrib><creatorcontrib>Nagai, Minako</creatorcontrib><creatorcontrib>Nakagawa, Kenji</creatorcontrib><creatorcontrib>Takagi, Tadataka</creatorcontrib><creatorcontrib>Ikeda, Naoya</creatorcontrib><title>New insight into the association between bile infection and clinically relevant pancreatic fistula in patients undergoing pancreatoduodenectomy</title><title>Journal of hepato-biliary-pancreatic sciences</title><addtitle>J Hepatobiliary Pancreat Sci</addtitle><description>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 &lt; .001). Multivariable logistic regression analysis showed that the presence of E faecalis in bile was independently associated with CR‐POPF. Conclusions The detection of both bile and postoperative abdominal fluid infections can be more accurate in predicting CR‐POPF. Furthermore, the presence of E faecalis in bile may serve as a novel surrogate marker for CR‐POPF. Nakamura and colleagues showed that the detection of both bile infection and postoperative abdominal fluid infection may more accurately predict the development of clinically relevant postoperative pancreatic fistula after pancreatoduodenectomy. The presence of Enterococcus faecalis in bile may serve as a novel surrogate marker for clinically relevant postoperative pancreatic fistula.</description><subject>Bile</subject><subject>Enterococcus faecalis</subject><subject>Fistula</subject><subject>intraoperative bile sampling</subject><subject>pancreatic fistula</subject><subject>Pancreaticoduodenectomy</subject><subject>pancreatoduodenectomy</subject><issn>1868-6974</issn><issn>1868-6982</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp1kV1rFDEUhoNUbKkFf0EJ9KY3U5NMZjJzWYtapagX7fWQj5PdLNlkm2S67K_wL5u1dQXB3Lzh8JyHkBehd5RcUULY-9VSba7EQF-hEzr0Q9OPAzs63AU_Rmc5r0g9LW3HlrxBxy3rSD9QdoJ-foMtdiG7xbLULBGXJWCZc9ROFhcDVlC2ADWdh0pY0L_HMhisvQtOS-93OIGHJxkK3sigE9RVja3LZfayLtVpcRBKxnMwkBbRhcWBjGaOBkL1xvXuLXptpc9w9pKn6OHTx_ub2-bu--cvN9d3jW5FS5tR69GA0cOoVcc7ozugjAs-jMJ0glLFFOFESWW1sIabHrrOcGaU5RSspe0punz2blJ8nCGXae2yBu9lgDjniXFKBBM95RW9-AddxTmF-rpKCdYyIVj_V6hTzDmBnTbJrWXaTZRM-56mfU9T7ami5y_CWa3BHMA_rVSgeQa29c93_xVNX28__NgLfwGpeKB-</recordid><startdate>202012</startdate><enddate>202012</enddate><creator>Nakamura, Kota</creator><creator>Sho, Masayuki</creator><creator>Kinoshita, Shoichi</creator><creator>Akahori, Takahiro</creator><creator>Nagai, Minako</creator><creator>Nakagawa, Kenji</creator><creator>Takagi, Tadataka</creator><creator>Ikeda, Naoya</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6208-7661</orcidid></search><sort><creationdate>202012</creationdate><title>New insight into the association between bile infection and clinically relevant pancreatic fistula in patients undergoing pancreatoduodenectomy</title><author>Nakamura, Kota ; Sho, Masayuki ; Kinoshita, Shoichi ; Akahori, Takahiro ; Nagai, Minako ; Nakagawa, Kenji ; Takagi, Tadataka ; Ikeda, Naoya</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3731-9cc9dedc89cb545dc5e12474897d5711b2b040babfc7fd4d6e55d42dbf41eff13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Bile</topic><topic>Enterococcus faecalis</topic><topic>Fistula</topic><topic>intraoperative bile sampling</topic><topic>pancreatic fistula</topic><topic>Pancreaticoduodenectomy</topic><topic>pancreatoduodenectomy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nakamura, Kota</creatorcontrib><creatorcontrib>Sho, Masayuki</creatorcontrib><creatorcontrib>Kinoshita, Shoichi</creatorcontrib><creatorcontrib>Akahori, Takahiro</creatorcontrib><creatorcontrib>Nagai, Minako</creatorcontrib><creatorcontrib>Nakagawa, Kenji</creatorcontrib><creatorcontrib>Takagi, Tadataka</creatorcontrib><creatorcontrib>Ikeda, Naoya</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of hepato-biliary-pancreatic sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nakamura, Kota</au><au>Sho, Masayuki</au><au>Kinoshita, Shoichi</au><au>Akahori, Takahiro</au><au>Nagai, Minako</au><au>Nakagawa, Kenji</au><au>Takagi, Tadataka</au><au>Ikeda, Naoya</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>New insight into the association between bile infection and clinically relevant pancreatic fistula in patients undergoing pancreatoduodenectomy</atitle><jtitle>Journal of hepato-biliary-pancreatic sciences</jtitle><addtitle>J Hepatobiliary Pancreat Sci</addtitle><date>2020-12</date><risdate>2020</risdate><volume>27</volume><issue>12</issue><spage>992</spage><epage>1001</epage><pages>992-1001</pages><issn>1868-6974</issn><eissn>1868-6982</eissn><abstract>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 &lt; .001). Multivariable logistic regression analysis showed that the presence of E faecalis in bile was independently associated with CR‐POPF. Conclusions The detection of both bile and postoperative abdominal fluid infections can be more accurate in predicting CR‐POPF. Furthermore, the presence of E faecalis in bile may serve as a novel surrogate marker for CR‐POPF. Nakamura and colleagues showed that the detection of both bile infection and postoperative abdominal fluid infection may more accurately predict the development of clinically relevant postoperative pancreatic fistula after pancreatoduodenectomy. The presence of Enterococcus faecalis in bile may serve as a novel surrogate marker for clinically relevant postoperative pancreatic fistula.</abstract><cop>Japan</cop><pub>Wiley Subscription Services, Inc</pub><pmid>32506812</pmid><doi>10.1002/jhbp.781</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-6208-7661</orcidid></addata></record>
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subjects Bile
Enterococcus faecalis
Fistula
intraoperative bile sampling
pancreatic fistula
Pancreaticoduodenectomy
pancreatoduodenectomy
title New insight into the association between bile infection and clinically relevant pancreatic fistula in patients undergoing pancreatoduodenectomy
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