PancreasBacterobilia may trigger the development and severity of pancreatic fistula after pancreatoduodenectomy
Section snippets
Patients and operative procedures
A retrospective review was conducted using a prospectively collected database of patients who underwent PD between November 2010 and July 2014 at the Shizuoka Cancer Center. This study was approved by the institutional review board of the Shizuoka Cancer Center. Our standard operation for resection of neoplasms of the head of the pancreas is a subtotal stomach-preserving pancreatoduodenectomy using the modified Child's method. Pancreaticojejunostomy was performed, consisting of approximation of
Results
A total of 264 patients (male, n = 171 [65%]; female, n = 93 [45%]) with a median age of 69 years (IQR, 62–75 years) were enrolled in this study. One hundred thirty (49%) of these patients had pancreatic cancer; 44 (17%) had bile duct cancer; 30 (11%) had ampullary cancer; 20 (8%) had an intraductal papillary mucinous neoplasm; 15 (6%) had duodenal cancer; and the remaining 25 (9%) had other diseases. One hundred forty-four (55%) of the patients underwent preoperative PBD, and the median
Discussion
Although multiple risk factors for POPF have been evaluated in previous studies,3, 4, 16, 17, 18, 19 no reports have clarified the correlation between intraoperative bile cultures and POPF. Our study showed a significant association between a positive intraoperative bile culture and development of grade B/C POPFs. In addition, the incidence of intra-abdominal hemorrhage, a critical complication related to POPF, and wound infection were also significantly greater in patients with a positive
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