The effect of preoperative biliary drainage on infectious complications after hepatobiliary resection with cholangiojejunostomy

Sugawara, Gen; Ebata, Tomoki; Yokoyama, Yukihiro; Igami, Tsuyoshi; Takahashi, Yu; Takara, Daisuke; Nagino, Masato

doi:10.1016/j.surg.2012.07.032

Cited by 71 publications

(82 citation statements)

References 42 publications

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“…Thus, one might conclude that nowadays such complex surgical procedures are still associated with increased rates of postoperative complications. 27 It was suggested as a potential detrimental effect of the postoperative complications on long-term outcomes, 9 but our previous studies failed to sustain this finding after curative-intent surgery for Klatskin tumors. 28 The ISGLS grading system for posthepatectomy specific complications is only retrospectively assessed and is not useful to predict morbidity in early settings, but is of real value for surgical audit.…”

Section: Discussionmentioning

confidence: 89%

Major hepatectomies for perihilar cholangiocarcinoma: Predictors for clinically relevant postoperative complications using the International Study Group of Liver Surgery definitions

Dumitraşcu

Brasoveanu

Stroescu

et al. 2016

Asian Journal of Surgery

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Clinically relevant morbidity rates after major hepatectomies for perihilar cholangiocarcinoma are high. Liver failure represents the main complication and is correlated with the number of transfused blood units. A patient with increased bilirubinemia appears to have a high risk for postoperative hemorrhage. Biliary drainage and portal vein resection does not appear to have a detrimental effect on morbidities. Neutrophil-to-lymphocyte ratio is a novel independent predictor for severe morbidity after major hepatectomies for perihilar cholangiocarcinoma and may contribute to better and informed decision-making.

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Section: Discussionmentioning

confidence: 89%

Major hepatectomies for perihilar cholangiocarcinoma: Predictors for clinically relevant postoperative complications using the International Study Group of Liver Surgery definitions

Dumitraşcu

Brasoveanu

Stroescu

et al. 2016

Asian Journal of Surgery

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“…In cases of extended hepatectomy for hilar bile duct carcinoma, patients with bile infection experience postoperative infectious complications more often than those without bile infection [67] and the microorganisms isolated from postoperative infections are identical to those found in the preoperative cultures in 30-88% of cases [89][90][91]. Therefore, identification of microorganisms in bile before surgery is necessary to enable selection of appropriate prophylactic and/or therapeutic antibiotics [91][92][93].…”

Section: Cq11: What Is the Best Treatment For Fever In Patients Who Hmentioning

confidence: 99%

Clinical practice guidelines for the management of biliary tract cancers 2015: the 2^nd English edition

Miyazaki

Yoshitomi

Miyakawa³

et al. 2015

J Hepato Biliary Pancreat

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236

165

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Background The Japanese Society of Hepato-Biliary-Pancreatic Surgery launched the clinical practice guidelines for the management of biliary tract and ampullary carcinomas in 2008. Novel treatment modalities and handling of clinical issues have been proposed after the publication. New approaches for editing clinical guidelines, such as the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system, also have been introduced for better and clearer grading of recommendations. Methods Clinical questions (CQs) were proposed in seven topics. Recommendation, grade of recommendation and statement for each CQ were discussed and finalized by evidencebased approach. Recommendation was graded to grade 1 (strong) and 2 (weak) according to the concept of GRADE system. Results The 29 CQs covered seven topics: (1) prophylactic treatment, (2) diagnosis, (3) biliary drainage, (4) surgical treatment, (5) chemotherapy, (6) radiation therapy, and (7) pathology. In 27 CQs, 19 recommendations were rated strong and 11 recommendations weak. Each CQ included the statement of how the recommendation was graded. Conclusions This guideline provides recommendation for important clinical aspects based on evidence. Future collaboration with cancer registry will be a key for assessment of the guidelines and establishment of new evidence. Free full-text articles and a mobile application of this guideline are available via

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“…RT-qPCR was performed to detect representative bacteria associated with POICs and that were considered pathogenic based on previous studies [5,6,15] . The examined bacteria included obligate anaerobes ( Clostridium coccoides group, Clostridium leptum subgroup, Bacteroides fragiles group, Atopobium cluster, Prevotella and Clostridium perfringens ), facultative anaerobes ( Enterobacteriaceae , Enterococcus , Streptococcus and Staphylococcus ), and aerobes ( Pseudomonas ).…”

Section: Detection Of Microorganisms In Lymph Nodes and Bloodmentioning

confidence: 99%

Effect of Perioperative Synbiotic Treatment on Bacterial Translocation and Postoperative Infectious Complications after Pancreatoduodenectomy

Yokoyama

Miyake²,

Kokuryo³

et al. 2016

Dig Surg

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Background/Aims: This study investigated the effect of perioperative synbiotics on bacterial translocation to mesenteric lymph nodes (MLNs) and occurrence of infectious complications following pancreatoduodenectomy (PD; University Hospital Medical Information Network ID 000003705). Methods: Patients who were scheduled to undergo PD were randomized to receive preoperative synbiotics or no synbiotics (control group). MLNs were harvested at laparotomy (MLN-1) and after the resection (MLN-2). Blood samples were collected before laparotomy (Blood-1) and on postoperative day 1 (Blood-2). Microorganisms in each sample were detected using a bacterium-specific ribosomal RNA-targeted reverse transcriptase-quantitative polymerase chain reaction. Results: Forty-four patients were included. In all samples, the bacterial detection rate in the MLN-1, MLN-2, Blood-1, and Blood-2 was lower in the synbiotics group than in the control group, although it did not reach a statistically significant difference. There was a significant correlation between the positivity of bacteria in the MLN-2 and Blood-2 samples (p = 0.009). The incidence rate of overall infectious complications was not significantly different between the 2 groups. Among various perioperative factors, the incidence of pancreatic fistula was the only factor that had a significant association with the incidence of infectious complications. Conclusion: The preoperative use of synbiotics did not affect the incidence of infectious complications following PD.

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The effect of preoperative biliary drainage on infectious complications after hepatobiliary resection with cholangiojejunostomy

Cited by 71 publications

References 42 publications

Major hepatectomies for perihilar cholangiocarcinoma: Predictors for clinically relevant postoperative complications using the International Study Group of Liver Surgery definitions

Major hepatectomies for perihilar cholangiocarcinoma: Predictors for clinically relevant postoperative complications using the International Study Group of Liver Surgery definitions

Clinical practice guidelines for the management of biliary tract cancers 2015: the 2^nd English edition

Effect of Perioperative Synbiotic Treatment on Bacterial Translocation and Postoperative Infectious Complications after Pancreatoduodenectomy

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The effect of preoperative biliary drainage on infectious complications after hepatobiliary resection with cholangiojejunostomy

Cited by 71 publications

References 42 publications

Major hepatectomies for perihilar cholangiocarcinoma: Predictors for clinically relevant postoperative complications using the International Study Group of Liver Surgery definitions

Major hepatectomies for perihilar cholangiocarcinoma: Predictors for clinically relevant postoperative complications using the International Study Group of Liver Surgery definitions

Clinical practice guidelines for the management of biliary tract cancers 2015: the 2nd English edition

Effect of Perioperative Synbiotic Treatment on Bacterial Translocation and Postoperative Infectious Complications after Pancreatoduodenectomy

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Product

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Clinical practice guidelines for the management of biliary tract cancers 2015: the 2^nd English edition