Specific intraoperative antibiotic therapy abrogates the negative effect of biliary contamination on the Comprehensive Complication Index after pancreatic head resection

Pretzsch, Elise; A, Heim; Heiliger, Christian; Pretzsch, Charlotte M.; Ilmer, Matthias; Weniger, Maximilian; Renz, Bernhard W.; Guba, Markus; Angele, Martin K.; D’Haese, Jan G.; Werner, Jens; Nieß, Hanno

doi:10.1016/j.surg.2021.10.022

Cited by 5 publications

(4 citation statements)

References 30 publications

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“…22 However, other studies have shown that there is no association. 24,25,44 The only postoperative complication that has been repeatedly shown to have an association with a positive IOBC is a surgical site infection (SSI). 22,25,27,48,49 The results of this study disagree with the five referenced studies; however, SSIs and other AEs can contribute to a prolonged hospital stay, increase morbidity, increase mortality, increase readmission, and higher healthcare costs.…”

Section: Discussionmentioning

confidence: 99%

“…Some studies have shown that a positive IOBC is associated with the development of a postoperative pancreatic fistula 22 . However, other studies have shown that there is no association 24,25,44 . The only postoperative complication that has been repeatedly shown to have an association with a positive IOBC is a surgical site infection (SSI) 22,25,27,48,49 .…”

Section: Discussionmentioning

confidence: 99%

“…IOBCs are commonly performed during pancreatic surgery; however, interpreting and acting upon the results remains unstandardized 20 . There has been limited evidence that a positive IOBC could aid in perioperative AE management 21–24 . However, the topic remains controversial as many studies investigating the correlation between bacterobilia and overall postoperative mortality, morbidity, and length of hospital stay (LOHS) were contradictory 25–27 .…”

Section: Introductionmentioning

confidence: 99%

“…20 There has been limited evidence that a positive IOBC could aid in perioperative AE management. [21][22][23][24] However, the topic remains controversial as many studies investigating the correlation between bacterobilia and overall postoperative mortality, morbidity, and length of hospital stay (LOHS) were contradictory. [25][26][27] Although the debate on how to best manage a positive IOBC continues, its role in infection management in patients undergoing IRE has not been previously described in the literature.…”

mentioning

confidence: 99%

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Infection reporting in patients undergoing irreversible electroporation of locally advanced pancreatic cancer

Filson

Martin

2023

Journal of Surgical Oncology

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BackgroundIntraoperative bile cultures (IOBCs) taken during pancreatic surgery are commonly performed and there has been limited evidence that a positive IOBC could aid in perioperative adverse event (AE) management. Therefore, this study aims to describe infection management in patients undergoing irreversible electroporation (IRE).MethodsAn Institutional Review Board (IRB)‐approved prospective database was utilized from 8/2016 to 6/2022, with 127 pancreatic adenocarcinoma patients included.ResultsA total of 28 patients that underwent IRE also had a simultaneous positive IOBC and the remaining 99 patients that underwent IRE had negative IOBC. A total of 11(39%) of the patients with a positive IOBC had AE's, and 38 (38%) of the patients with negative IOBC had AE's. Both groups had similar rates of AEs leading to new hospitalization and prolonged hospitalizations. Overall, there was no correlation between a positive IOBC and a patient developing an AE.ConclusionsThe findings of this study provide insights that improve the infectious management of patients undergoing IRE.

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