Correlation between preoperative biliary drainage, bile duct contamination, and postoperative outcomes for pancreatic surgery

Limongelli, Paolo; Pai, Madhava; Bansi, Dev; Thiallinagram, Andrew; Tait, Paul; Jackson, James E.; Habib, Nagy; Williamson, R. C. N.; Jiao, Long R.

doi:10.1016/j.surg.2007.04.022

Cited by 105 publications

(113 citation statements)

References 25 publications

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“…25 Positive bile cultures secondary to PBD have been linked to infectious complications in other retrospective studies. 18,26,27 There was a statistical trend toward an increased risk of death in the no PBD patients. Among the five patients who died postoperatively, two had known operative complications at the time of their death; one patient had an anastomotic leak and the other patient died secondary to a portal vein thrombosis.…”

Section: Discussionmentioning

confidence: 90%

“…[12][13][14][15][17][18][19] Despite these data, PBD continues to be a frequently performed procedure in patients being considered for resection of periampullary malignancy. In the current study, the majority of patients (59%) who underwent PD for pancreatic adenocarcinoma at our institution between 2000 and 2005 underwent PBD during their diagnostic evaluation.…”

Section: Discussionmentioning

confidence: 99%

“…12,13 Other centers have also shown a correlation between PBD and operative time and blood loss, positive bile cultures, wound infections, and pancreatic fistulae. [14][15][16][17][18][19] In addition to perioperative complications, PBD procedures can result in significant complications that can potentially delay operative intervention. 16 Despite these data, PBD continues to be routine.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A Matched Case-Control Study of Preoperative Biliary Drainage in Patients with Pancreatic Adenocarcinoma: Routine Drainage Is Not Justified

Mezhir

Brennan

Baser

et al. 2009

Journal of Gastrointestinal Surgery

108

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A Matched Case-Control Study of Preoperative Biliary Drainage in Patients with Pancreatic Adenocarcinoma: Routine Drainage Is Not Justified

Mezhir

Brennan

Baser

et al. 2009

Journal of Gastrointestinal Surgery

108

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show abstract

“…Our study found postoperative complications to be an important factor in the survival of patients with ampullary carcinoma in univariate analysis. A positive intraoperative bile culture result has been shown to be associated with a higher infectious complication rate postoperatively [23]. Howard et al [11] found, on multivariate analysis, that tumor size, tumor grade, postoperative complications, and resection margins were the most important covariables affecting survival, but that the absence of postoperative complications provided the most benefit in reducing the risk of dying from the disease (hazard ratio, 0.68).…”

Section: Discussionmentioning

confidence: 99%

Survival analysis after pancreatic resection for ampullary and pancreatic head carcinoma: An analysis of clinicopathological factors

Sommerville

Limongelli

Pai

et al. 2009

Journal of Surgical Oncology

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“…Multiple studies have demonstrated that the organism causing SSI matches the isolate from bile but these studies have not specified if strain typing was done to confirm the same. 4,15,16 Further genomic analysis is needed in future studies focusing on this aspect.…”

mentioning

confidence: 99%

Correlation of intra-operative bile cultures with septic complications following biliary tract surgery

et al. 2016

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INTRODUCTIONRoutine intra-operative bile culture during biliary tract surgeries is a common practice among hepatobiliary surgeons. This is based on reports that bactibilia is a predictor of septic complications following these surgeries. 1,2Most of these studies have focused on impact of pre-operative biliary drainage on the biliary microflora and its resulting infectious complications. Bile-contaminated operations are reported to have a higher incidence of septic complications than non-bilecontaminated operations. 3There is high correlation of bile culture results with those from post-operative septic foci with concordance rates as high as 80-89%.4-6 Intra operative bile culture result was thus purported to guide early institution of appropriate in patients at risk of developing infectious complications and guide selection of appropriate antibiotic prophylaxis. This study was aimed at studying the microbiological profile of routine intraoperative bile cultures and correlate with the isolates from septic foci in those undergoing biliary tract surgeries. ABSTRACTBackground: Routine intra-operative bile culture during biliary tract surgeries is a common practice among hepatobiliary surgeons. This is based on reports that bactibilia is a predictor of septic complications following these surgeries. This study was aimed at studying the microbiological profile of routine intraoperative bile cultures and correlate with the isolates from septic foci in those undergoing biliary tract surgeries. Methods: A prospective database of all patients who underwent biliary tract surgeries between July2014 to June 2016 was taken up for analysis. Charts were reviewed with special focus on microbiological culture data yielded from both routine bile culture and those from septic complications were recorded and analyzed. Strain typing screening was done by comparing the antibiotic susceptibility profiles of various isolates in each patient. Results: Of the total one hundred and forty four patients undergoing biliary tract surgery, 46 patients (32%) had a positive bile culture. Of these cultures were positive in 30 out of 32 patients (94%) who had preoperative CBD stent in situ. Bile culture positivity rate was highest with CBD exploration cases and incidence of surgical site infections (SSI) was highest with pancreatoduodenectomy cases. There was no significant association between a positive bile culture and development of surgical site infection (p = 0.09). Conclusions: There is no significant association of a positive bile culture with risk of surgical site infections in patients undergoing biliary tract surgery. Even in patients with positive bile culture who develop surgical site infections, two third of them are caused by different strains.

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Correlation between preoperative biliary drainage, bile duct contamination, and postoperative outcomes for pancreatic surgery

Cited by 105 publications

References 25 publications

A Matched Case-Control Study of Preoperative Biliary Drainage in Patients with Pancreatic Adenocarcinoma: Routine Drainage Is Not Justified

A Matched Case-Control Study of Preoperative Biliary Drainage in Patients with Pancreatic Adenocarcinoma: Routine Drainage Is Not Justified

Survival analysis after pancreatic resection for ampullary and pancreatic head carcinoma: An analysis of clinicopathological factors

Correlation of intra-operative bile cultures with septic complications following biliary tract surgery

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