Skip to main content
Erschienen in: Indian Journal of Surgery 5/2019

03.08.2019 | Review Article

Bacteriobilia in Hepato-Pancreato-Biliary Surgery: an Enemy or a Friend in Disguise?

verfasst von: Rajvilas Narkhede, Gunjan Desai, Prasad Pande

Erschienen in: Indian Journal of Surgery | Ausgabe 5/2019

Einloggen, um Zugang zu erhalten

Abstract

Bacterial colonization of bile, known as bacteriobilia, is predisposed by biliary obstruction and/or biliary interventions. It can lead to an increase in postoperative infective complications through impairment of hepatic synthetic and immunological function and breakdown of intestinal mucosal barrier. However, various reports of bacteremia and increase in infective complications have not been translated into increased postoperative morbidity and mortality. Biliary interventions, including preoperative biliary drainage, have been shown to increase the rates of bacteriobilia, and in turn positive biliary cultures. However, the clinical implication of this biliary colonization and strategies to prevent postoperative infective complications are not well understood. Bacteriobilia may be difficult to prevent completely due to its occurrence from non-modifiable risk factors. However, sparing use of biliary interventions and early identification and treatment of bacteriobilia with culture-directed antibiotics can help prevent catastrophic postoperative infective complications. It is necessary for this culture-based practice to become part of a routine protocol, and every step must be taken to prevent bacteriobilia, and thereby avoid postoperative infective complications and optimize patient outcome.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Kneuertz P, Pitt H, Bilimoria K, Smiley J, Cohen M, Ko C, Pawlik T (2012) Risk of morbidity and mortality following hepato-pancreato-biliary surgery. J Gastrointest Surg 16(9):1727–1735PubMed Kneuertz P, Pitt H, Bilimoria K, Smiley J, Cohen M, Ko C, Pawlik T (2012) Risk of morbidity and mortality following hepato-pancreato-biliary surgery. J Gastrointest Surg 16(9):1727–1735PubMed
2.
Zurück zum Zitat Ceppa E, Pitt H, House M, Kilbane E, Nakeeb A, Schmidt C, Zyromski N, Lillemoe K (2013) Reducing surgical site infections in hepatopancreatobiliary surgery. HPB 15(5):384–391PubMed Ceppa E, Pitt H, House M, Kilbane E, Nakeeb A, Schmidt C, Zyromski N, Lillemoe K (2013) Reducing surgical site infections in hepatopancreatobiliary surgery. HPB 15(5):384–391PubMed
3.
Zurück zum Zitat Hoshino S, Sun Z, Uchikura K, Tsugane K, Ceppa E, Bulkley GB et al Biliary obstruction reduces hepatic killing and phagocytic clearance of circulating microorganisms in rats. J Gastrointest Surg 7(4):497–506PubMed Hoshino S, Sun Z, Uchikura K, Tsugane K, Ceppa E, Bulkley GB et al Biliary obstruction reduces hepatic killing and phagocytic clearance of circulating microorganisms in rats. J Gastrointest Surg 7(4):497–506PubMed
4.
Zurück zum Zitat Ding JW, Andersson R, Soltesz V, Willén R, Bengmark S (1994) Obstructive jaundice impairs reticuloendothelial function and promotes bacterial translocation in the rat. J Surg Res 57(2):238–245PubMed Ding JW, Andersson R, Soltesz V, Willén R, Bengmark S (1994) Obstructive jaundice impairs reticuloendothelial function and promotes bacterial translocation in the rat. J Surg Res 57(2):238–245PubMed
5.
Zurück zum Zitat Tomioka M, Iinuma H, Okinaga K (2000) Impaired Kupffer cell function and effect of immunotherapy in obstructive jaundice. J Surg Res 92(2):276–282PubMed Tomioka M, Iinuma H, Okinaga K (2000) Impaired Kupffer cell function and effect of immunotherapy in obstructive jaundice. J Surg Res 92(2):276–282PubMed
6.
Zurück zum Zitat Fathi A, Jackson T, Barati M, Eghbalieh B, Siegel K, Siegel C (2016) Extended perioperative antibiotic coverage in conjunction with intraoperative bile cultures decreases infectious complications after pancreaticoduodenectomy. HPB Surg 2016:1–6 Fathi A, Jackson T, Barati M, Eghbalieh B, Siegel K, Siegel C (2016) Extended perioperative antibiotic coverage in conjunction with intraoperative bile cultures decreases infectious complications after pancreaticoduodenectomy. HPB Surg 2016:1–6
7.
Zurück zum Zitat Sourrouille I, Gaujoux S, Lacave G, Bert F, Dokmak S, Belghiti J, Paugam-Burtz C, Sauvanet A (2013) Five days of postoperative antimicrobial therapy decreases infectious complications following pancreaticoduodenectomy in patients at risk for bile contamination. HPB [Oxford] 15(6):473–480 Sourrouille I, Gaujoux S, Lacave G, Bert F, Dokmak S, Belghiti J, Paugam-Burtz C, Sauvanet A (2013) Five days of postoperative antimicrobial therapy decreases infectious complications following pancreaticoduodenectomy in patients at risk for bile contamination. HPB [Oxford] 15(6):473–480
8.
Zurück zum Zitat Ghahramani L, Jahromi M, Pouladfar G, Safarpour A, Hosseini S, Aminshahidi M (2017) Bactobilia among patients with uncomplicated cholelithiasis undergoing laparoscopic cholecystectomy: the risk factors and effects on postoperative infectious complications. Annals of Colorectal Research. https://doi.org/10.5812/acr.12795 Ghahramani L, Jahromi M, Pouladfar G, Safarpour A, Hosseini S, Aminshahidi M (2017) Bactobilia among patients with uncomplicated cholelithiasis undergoing laparoscopic cholecystectomy: the risk factors and effects on postoperative infectious complications. Annals of Colorectal Research. https://​doi.​org/​10.​5812/​acr.​12795
9.
Zurück zum Zitat Csendes A, Burdiles P, Maluenda F, Diaz JC, Csendes P, Mitru N (1996) Simultaneous bacteriologic assessment of bile from gallbladder and common bile duct in control subjects and patients with gallstones and common duct stones. Arch Surg 131(4):389–394PubMed Csendes A, Burdiles P, Maluenda F, Diaz JC, Csendes P, Mitru N (1996) Simultaneous bacteriologic assessment of bile from gallbladder and common bile duct in control subjects and patients with gallstones and common duct stones. Arch Surg 131(4):389–394PubMed
10.
Zurück zum Zitat Kaya M, Beştaş R, Bacalan F, Bacaksız F, Arslan EG, Kaplan MA (2012) Microbial profile and antibiotic sensitivity pattern in bile cultures from endoscopic retrograde cholangiography patients. World J Gastroenterol 18(27):3585–3589PubMedPubMedCentral Kaya M, Beştaş R, Bacalan F, Bacaksız F, Arslan EG, Kaplan MA (2012) Microbial profile and antibiotic sensitivity pattern in bile cultures from endoscopic retrograde cholangiography patients. World J Gastroenterol 18(27):3585–3589PubMedPubMedCentral
11.
Zurück zum Zitat Csendes A, Mitru N, Maluenda F, Diaz JC, Burdiles P, Csendes P et al Counts of bacteria and pyocites of choledochal bile in controls and in patients with gallstones or common bile duct stones with or without acute cholangitis. Hepatogastroenterology 43(10):800–806 Csendes A, Mitru N, Maluenda F, Diaz JC, Burdiles P, Csendes P et al Counts of bacteria and pyocites of choledochal bile in controls and in patients with gallstones or common bile duct stones with or without acute cholangitis. Hepatogastroenterology 43(10):800–806
12.
Zurück zum Zitat Yu H, Guo Z, Xing W, Guo X, Liu F, Li B (2012) Bile culture and susceptibility testing of malignant biliary obstruction via PTBD. Cardiovasc Intervent Radiol 35(5):1136–1144PubMed Yu H, Guo Z, Xing W, Guo X, Liu F, Li B (2012) Bile culture and susceptibility testing of malignant biliary obstruction via PTBD. Cardiovasc Intervent Radiol 35(5):1136–1144PubMed
13.
Zurück zum Zitat Mandryka Y, Klimczak J, Duszewski M, Kondras M, Modzelewski B (2006) Bile duct infections as a late complication after endoscopic sphincterotomy. Pol Merkur Lekarski 21(126):525–527PubMed Mandryka Y, Klimczak J, Duszewski M, Kondras M, Modzelewski B (2006) Bile duct infections as a late complication after endoscopic sphincterotomy. Pol Merkur Lekarski 21(126):525–527PubMed
14.
Zurück zum Zitat Munro R, Sorrell TC (1986) Biliary sepsis. Reviewing treatment options. Drugs. 31(5):449–454PubMed Munro R, Sorrell TC (1986) Biliary sepsis. Reviewing treatment options. Drugs. 31(5):449–454PubMed
15.
Zurück zum Zitat Isla AM, Griniatsos J, Riaz A, Karvounis E, Williamson RCN (2007) Pancreaticoduodenectomy for periampullary malignancies: the effect of bile colonization on the postoperative outcome. Langenbeck's Arch Surg 392(1):67–73 Isla AM, Griniatsos J, Riaz A, Karvounis E, Williamson RCN (2007) Pancreaticoduodenectomy for periampullary malignancies: the effect of bile colonization on the postoperative outcome. Langenbeck's Arch Surg 392(1):67–73
16.
Zurück zum Zitat Sung JY, Costerton JW, Shaffer EA (1992) Defense system in the biliary tract against bacterial infection. Dig Dis Sci. Kluwer Academic Publishers-Plenum Publishers; 37(5):689–96 Sung JY, Costerton JW, Shaffer EA (1992) Defense system in the biliary tract against bacterial infection. Dig Dis Sci. Kluwer Academic Publishers-Plenum Publishers; 37(5):689–96
17.
Zurück zum Zitat Park S-Y, Park C-H, Cho S-B, Lee W-S, Kim J-C, Cho C-K, Joo YE, Kim HS, Choi SK, Rew JS (2011) What is appropriate procedure for preoperative biliary drainage in patients with obstructive jaundice awaiting pancreaticoduodenectomy? Surg Laparosc Endosc Percutan Tech 21(5):344–348PubMed Park S-Y, Park C-H, Cho S-B, Lee W-S, Kim J-C, Cho C-K, Joo YE, Kim HS, Choi SK, Rew JS (2011) What is appropriate procedure for preoperative biliary drainage in patients with obstructive jaundice awaiting pancreaticoduodenectomy? Surg Laparosc Endosc Percutan Tech 21(5):344–348PubMed
18.
Zurück zum Zitat Koivusalo A, Mäkisalo H, Talja M, Siitonen A, Vuopio-Varkila J, Ruutu M, Höckerstedt K (1996) Bacterial adherence and biofilm formation on latex and silicone T-tubes in relation to bacterial contamination of bile. Scand J Gastroenterol 31(4):398–403PubMed Koivusalo A, Mäkisalo H, Talja M, Siitonen A, Vuopio-Varkila J, Ruutu M, Höckerstedt K (1996) Bacterial adherence and biofilm formation on latex and silicone T-tubes in relation to bacterial contamination of bile. Scand J Gastroenterol 31(4):398–403PubMed
19.
Zurück zum Zitat Howard TJ, Yu J, Greene RB, George V, Wairiuko GM, Moore SA et al (2006) Influence of bactibilia after preoperative biliary stenting on postoperative infectious complications. J Gastrointest Surg 10(4):523–531PubMed Howard TJ, Yu J, Greene RB, George V, Wairiuko GM, Moore SA et al (2006) Influence of bactibilia after preoperative biliary stenting on postoperative infectious complications. J Gastrointest Surg 10(4):523–531PubMed
20.
Zurück zum Zitat Hochwald SN, Burke EC, Jarnagin WR, Fong Y, Blumgart LH (1999) Association of preoperative biliary stenting with increased postoperative infectious complications in proximal cholangiocarcinoma. Arch Surg 134(3):261–266PubMed Hochwald SN, Burke EC, Jarnagin WR, Fong Y, Blumgart LH (1999) Association of preoperative biliary stenting with increased postoperative infectious complications in proximal cholangiocarcinoma. Arch Surg 134(3):261–266PubMed
21.
Zurück zum Zitat Rerknimitr R, Fogel EL, Kalayci C, Esber E, Lehman GA, Sherman S (2002) Microbiology of bile in patients with cholangitis or cholestasis with and without plastic biliary endoprosthesis. Gastrointest Endosc 56(6):885–889PubMed Rerknimitr R, Fogel EL, Kalayci C, Esber E, Lehman GA, Sherman S (2002) Microbiology of bile in patients with cholangitis or cholestasis with and without plastic biliary endoprosthesis. Gastrointest Endosc 56(6):885–889PubMed
22.
Zurück zum Zitat Scott-Conner CE, Grogan JB (1994) The pathophysiology of biliary obstruction and its effect on phagocytic and immune function. J Surg Res 57(2):316–336PubMed Scott-Conner CE, Grogan JB (1994) The pathophysiology of biliary obstruction and its effect on phagocytic and immune function. J Surg Res 57(2):316–336PubMed
23.
Zurück zum Zitat Flores C, Maguilnik I, Hadlich E, Goldani LZ. Microbiology of choledochal bile in patients with choledocholithiasis admitted to a tertiary hospital. J Gastroenterol Hepatol 2003 18[3]:333–336PubMed Flores C, Maguilnik I, Hadlich E, Goldani LZ. Microbiology of choledochal bile in patients with choledocholithiasis admitted to a tertiary hospital. J Gastroenterol Hepatol 2003 18[3]:333–336PubMed
24.
Zurück zum Zitat Karpel E, Madej A, Bułdak Ł, Duława-Bułdak A, Nowakowska-Duława E, Łabuzek K et al (2011) Bile bacterial flora and its in vitro resistance pattern in patients with acute cholangitis resulting from choledocholithiasis. Scand J Gastroenterol 46(7–8):925–930PubMed Karpel E, Madej A, Bułdak Ł, Duława-Bułdak A, Nowakowska-Duława E, Łabuzek K et al (2011) Bile bacterial flora and its in vitro resistance pattern in patients with acute cholangitis resulting from choledocholithiasis. Scand J Gastroenterol 46(7–8):925–930PubMed
25.
Zurück zum Zitat Salvador VBDG, Lozada MCH, Consunji RJ (2011) Microbiology and antibiotic susceptibility of organisms in bile cultures from patients with and without cholangitis at an Asian Academic Medical Center. Surg Infect 12(2):105–111 Salvador VBDG, Lozada MCH, Consunji RJ (2011) Microbiology and antibiotic susceptibility of organisms in bile cultures from patients with and without cholangitis at an Asian Academic Medical Center. Surg Infect 12(2):105–111
26.
Zurück zum Zitat Kiesslich R, Holfelder M, Will D, Hahn M, Nafe B, Genitsariotis R et al (2001) Interventional ERCP in patients with cholestasis. Degree of biliary bacterial colonization and antibiotic resistance. Z Gastroenterol 39(12):985–992PubMed Kiesslich R, Holfelder M, Will D, Hahn M, Nafe B, Genitsariotis R et al (2001) Interventional ERCP in patients with cholestasis. Degree of biliary bacterial colonization and antibiotic resistance. Z Gastroenterol 39(12):985–992PubMed
27.
Zurück zum Zitat Lorenz R, Herrmann M, Kassem AM, Lehn N, Neuhaus H, Classen M (1998) Microbiological examinations and in-vitro testing of different antibiotics in therapeutic endoscopy of the biliary system. Endoscopy. 30(8):708–712PubMed Lorenz R, Herrmann M, Kassem AM, Lehn N, Neuhaus H, Classen M (1998) Microbiological examinations and in-vitro testing of different antibiotics in therapeutic endoscopy of the biliary system. Endoscopy. 30(8):708–712PubMed
28.
Zurück zum Zitat Rösch T, Triptrap A, Born P, Ott R, Weigert N, Frimberger E, Allescher HD, Classen M, Kamereck K (2003) Bacteriobilia in percutaneous transhepatic biliary drainage: occurrence over time and clinical sequelae. A prospective observational study. Scand J Gastroenterol 38(11):1162–1168PubMed Rösch T, Triptrap A, Born P, Ott R, Weigert N, Frimberger E, Allescher HD, Classen M, Kamereck K (2003) Bacteriobilia in percutaneous transhepatic biliary drainage: occurrence over time and clinical sequelae. A prospective observational study. Scand J Gastroenterol 38(11):1162–1168PubMed
29.
Zurück zum Zitat Itoh N, Kawamura I, Tsukahara M, Mori K, Kurai H (2016) Evaluation of Streptococcus pneumoniae in bile samples : a case series review. J Infect Chemother Elsevier Ltd; 2–5 Itoh N, Kawamura I, Tsukahara M, Mori K, Kurai H (2016) Evaluation of Streptococcus pneumoniae in bile samples : a case series review. J Infect Chemother Elsevier Ltd; 2–5
30.
Zurück zum Zitat Sakata J, Shirai Y, Tsuchiya Y, Wakai T, Nomura T, Hatakeyama K (2009) Preoperative cholangitis independently increases in-hospital mortality after combined major hepatic and bile duct resection for hilar cholangiocarcinoma. Langenbeck's Arch Surg 394(6):1065–1072 Sakata J, Shirai Y, Tsuchiya Y, Wakai T, Nomura T, Hatakeyama K (2009) Preoperative cholangitis independently increases in-hospital mortality after combined major hepatic and bile duct resection for hilar cholangiocarcinoma. Langenbeck's Arch Surg 394(6):1065–1072
31.
Zurück zum Zitat Park JW, Lee JK, Lee KT, Lee KH, Sung YK, Kang C-I (2014) How to interpret the bile culture results of patients with biliary tract infections. Clin Res Hepatol Gastroenterol 38(3):300–309PubMed Park JW, Lee JK, Lee KT, Lee KH, Sung YK, Kang C-I (2014) How to interpret the bile culture results of patients with biliary tract infections. Clin Res Hepatol Gastroenterol 38(3):300–309PubMed
32.
Zurück zum Zitat Qiu Y-D, Bai J-L, Xu F-G, Ding Y-T (2011) Effect of preoperative biliary drainage on malignant obstructive jaundice: a meta-analysis. World J Gastroenterol 17(3):391–396PubMedPubMedCentral Qiu Y-D, Bai J-L, Xu F-G, Ding Y-T (2011) Effect of preoperative biliary drainage on malignant obstructive jaundice: a meta-analysis. World J Gastroenterol 17(3):391–396PubMedPubMedCentral
33.
Zurück zum Zitat Pisters PW, Hudec WA, Hess KR, Lee JE, Vauthey JN, Lahoti S et al (2001) Effect of preoperative biliary decompression on pancreaticoduodenectomy-associated morbidity in 300 consecutive patients. Ann Surg 234(1):47–55PubMedPubMedCentral Pisters PW, Hudec WA, Hess KR, Lee JE, Vauthey JN, Lahoti S et al (2001) Effect of preoperative biliary decompression on pancreaticoduodenectomy-associated morbidity in 300 consecutive patients. Ann Surg 234(1):47–55PubMedPubMedCentral
34.
Zurück zum Zitat Barreto SG, Singh A, Perwaiz A, Singh T, Singh MK, Sharma S. (2017) Perioperative antimicrobial therapy in preventing complications following pancreatoduodenectomy infectious. [October]:514–9 Barreto SG, Singh A, Perwaiz A, Singh T, Singh MK, Sharma S. (2017) Perioperative antimicrobial therapy in preventing complications following pancreatoduodenectomy infectious. [October]:514–9
35.
Zurück zum Zitat Olsson G, Frozanpor F, Lundell L, Enochsson L, Ansorge C, Chiaro M Del, et al. Preoperative biliary drainage by plastic or self-expandable metal stents in patients with periampullary tumors : results of a randomized clinical study Authors. 2017;798–808 Olsson G, Frozanpor F, Lundell L, Enochsson L, Ansorge C, Chiaro M Del, et al. Preoperative biliary drainage by plastic or self-expandable metal stents in patients with periampullary tumors : results of a randomized clinical study Authors. 2017;798–808
36.
Zurück zum Zitat Jagannath P, Dhir V, Shrikhande S, Shah RC, Mullerpatan P, Mohandas KM (2005) Effect of preoperative biliary stenting on immediate outcome after pancreaticoduodenectomy. Br J Surg 92(3):356–361PubMed Jagannath P, Dhir V, Shrikhande S, Shah RC, Mullerpatan P, Mohandas KM (2005) Effect of preoperative biliary stenting on immediate outcome after pancreaticoduodenectomy. Br J Surg 92(3):356–361PubMed
37.
Zurück zum Zitat Singhirunnusorn J, Roger L, Chopin-Laly X, Lepilliez V, Ponchon T, Adham M. Value of preoperative biliary drainage in a consecutive series of resectable periampullary lesions. From randomized studies to real medical practice. Langenbecks Arch Surg. 2013 398[2]:295–302PubMed Singhirunnusorn J, Roger L, Chopin-Laly X, Lepilliez V, Ponchon T, Adham M. Value of preoperative biliary drainage in a consecutive series of resectable periampullary lesions. From randomized studies to real medical practice. Langenbecks Arch Surg. 2013 398[2]:295–302PubMed
38.
Zurück zum Zitat Sohn TA, Yeo CJ, Cameron JL, Pitt HA, Lillemoe KD Do preoperative biliary stents increase postpancreaticoduodenectomy complications? J Gastrointest Surg 4(3):258–267 discussion 267-8PubMed Sohn TA, Yeo CJ, Cameron JL, Pitt HA, Lillemoe KD Do preoperative biliary stents increase postpancreaticoduodenectomy complications? J Gastrointest Surg 4(3):258–267 discussion 267-8PubMed
39.
Zurück zum Zitat Mezhir JJ, Brennan MF, Baser RE, D’Angelica MI, Fong Y, DeMatteo RP et al (2009) A matched case-control study of preoperative biliary drainage in patients with pancreatic adenocarcinoma: routine drainage is not justified. J Gastrointest Surg 13(12):2163–2169PubMed Mezhir JJ, Brennan MF, Baser RE, D’Angelica MI, Fong Y, DeMatteo RP et al (2009) A matched case-control study of preoperative biliary drainage in patients with pancreatic adenocarcinoma: routine drainage is not justified. J Gastrointest Surg 13(12):2163–2169PubMed
40.
Zurück zum Zitat di Mola FF, Tavano F, Rago RR, De Bonis A, Valvano MR, Andriulli A et al (2014) Influence of preoperative biliary drainage on surgical outcome after pancreaticoduodenectomy: single centre experience. Langenbeck's Arch Surg 399(5):649–657 di Mola FF, Tavano F, Rago RR, De Bonis A, Valvano MR, Andriulli A et al (2014) Influence of preoperative biliary drainage on surgical outcome after pancreaticoduodenectomy: single centre experience. Langenbeck's Arch Surg 399(5):649–657
41.
Zurück zum Zitat Limongelli P, Pai M, Bansi D, Thiallinagram A, Tait P, Jackson J, Habib NA, Williamson RCN, Jiao LR (2007) Correlation between preoperative biliary drainage, bile duct contamination, and postoperative outcomes for pancreatic surgery. Surgery. 142(3):313–318PubMed Limongelli P, Pai M, Bansi D, Thiallinagram A, Tait P, Jackson J, Habib NA, Williamson RCN, Jiao LR (2007) Correlation between preoperative biliary drainage, bile duct contamination, and postoperative outcomes for pancreatic surgery. Surgery. 142(3):313–318PubMed
42.
Zurück zum Zitat Grizas S, Stakyte M, Kincius M, Barauskas G, Pundzius J (2005) Etiology of bile infection and its association with postoperative complications following pancreatoduodenectomy. Medicina [Kaunas] 41(5):386–391 Grizas S, Stakyte M, Kincius M, Barauskas G, Pundzius J (2005) Etiology of bile infection and its association with postoperative complications following pancreatoduodenectomy. Medicina [Kaunas] 41(5):386–391
43.
Zurück zum Zitat Guglielminetti D, Campanini A, Gardini G, Alberti L, Poddie D The correlation of bacteriobilia/wound infections in elective biliary surgery. G Chir 12(1–2):34–36 Guglielminetti D, Campanini A, Gardini G, Alberti L, Poddie D The correlation of bacteriobilia/wound infections in elective biliary surgery. G Chir 12(1–2):34–36
44.
Zurück zum Zitat Povoski S, Karpeh M, Conlon K, Blumgart L, Brennan M (1998) Positive intraoperative bile cultures at the time of pancreaticoduodenectomy are associated with preoperative biliary drainage and subsequent development of postoperative infectious complications and mortality. Gastroenterology 114:A537 Povoski S, Karpeh M, Conlon K, Blumgart L, Brennan M (1998) Positive intraoperative bile cultures at the time of pancreaticoduodenectomy are associated with preoperative biliary drainage and subsequent development of postoperative infectious complications and mortality. Gastroenterology 114:A537
45.
Zurück zum Zitat Cortes A, Sauvanet A, Bert F, Janny S, Sockeel P, Kianmanesh R, Ponsot P, Ruszniewski P, Belghiti J (2006) Effect of bile contamination on immediate outcomes after pancreaticoduodenectomy for tumor. J Am Coll Surg 202(1):93–99PubMed Cortes A, Sauvanet A, Bert F, Janny S, Sockeel P, Kianmanesh R, Ponsot P, Ruszniewski P, Belghiti J (2006) Effect of bile contamination on immediate outcomes after pancreaticoduodenectomy for tumor. J Am Coll Surg 202(1):93–99PubMed
46.
Zurück zum Zitat Sarac F, Salman T, Gun F, Celik A, Gurler N, Dogru Abbasoglu S et al (2015) Effect of probiotic supplementation on bacterial translocation in common bile duct obstruction. Pediatr Surg Int 31(2):155–161PubMed Sarac F, Salman T, Gun F, Celik A, Gurler N, Dogru Abbasoglu S et al (2015) Effect of probiotic supplementation on bacterial translocation in common bile duct obstruction. Pediatr Surg Int 31(2):155–161PubMed
47.
Zurück zum Zitat Margaritis VG, Filos KS, Michalaki MA, Scopa CD, Spiliopoulou I, Nikolopoulou VN, Vagianos CE (2005) Effect of oral glutamine administration on bacterial tanslocation, endotoxemia, liver and ileal morphology, and apoptosis in rats with obstructive jaundice. World J Surg 29(10):1329–1334PubMed Margaritis VG, Filos KS, Michalaki MA, Scopa CD, Spiliopoulou I, Nikolopoulou VN, Vagianos CE (2005) Effect of oral glutamine administration on bacterial tanslocation, endotoxemia, liver and ileal morphology, and apoptosis in rats with obstructive jaundice. World J Surg 29(10):1329–1334PubMed
48.
Zurück zum Zitat Zulfikaroglu B, Zulfikaroglu E, Ozmen MM, Ozalp N, Berkem R, Erdogan S et al (2003) The effect of immunonutrition on bacterial translocation, and intestinal villus atrophy in experimental obstructive jaundice. Clin Nutr 22(3):277–281PubMed Zulfikaroglu B, Zulfikaroglu E, Ozmen MM, Ozalp N, Berkem R, Erdogan S et al (2003) The effect of immunonutrition on bacterial translocation, and intestinal villus atrophy in experimental obstructive jaundice. Clin Nutr 22(3):277–281PubMed
49.
Zurück zum Zitat Onder A, Kapan M, Yuksel H, Tekin R, Kele A, Evliyaoglu O et al The effects of erythropoietin on bacterial translocation and inflammation in rats with obstructive jaundice. Ann Ital Chir 85(2):159–165 Onder A, Kapan M, Yuksel H, Tekin R, Kele A, Evliyaoglu O et al The effects of erythropoietin on bacterial translocation and inflammation in rats with obstructive jaundice. Ann Ital Chir 85(2):159–165
50.
Zurück zum Zitat Scopa CD, Koureleas S, Tsamandas AC, Spiliopoulou I, Alexandrides T, Filos KS, Vagianos CE (2000) Beneficial effects of growth hormone and insulin-like growth factor I on intestinal bacterial translocation, endotoxemia, and apoptosis in experimentally jaundiced rats. J Am Coll Surg 190(4):423–431PubMed Scopa CD, Koureleas S, Tsamandas AC, Spiliopoulou I, Alexandrides T, Filos KS, Vagianos CE (2000) Beneficial effects of growth hormone and insulin-like growth factor I on intestinal bacterial translocation, endotoxemia, and apoptosis in experimentally jaundiced rats. J Am Coll Surg 190(4):423–431PubMed
Metadaten
Titel
Bacteriobilia in Hepato-Pancreato-Biliary Surgery: an Enemy or a Friend in Disguise?
verfasst von
Rajvilas Narkhede
Gunjan Desai
Prasad Pande
Publikationsdatum
03.08.2019
Verlag
Springer India
Erschienen in
Indian Journal of Surgery / Ausgabe 5/2019
Print ISSN: 0972-2068
Elektronische ISSN: 0973-9793
DOI
https://doi.org/10.1007/s12262-019-01933-0

Weitere Artikel der Ausgabe 5/2019

Indian Journal of Surgery 5/2019 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.