Detailed Abstract
[BP Poster Presentation 8 - Biliary & Pancreas (Pancreas Disease/Surgery)]
[BP PP 8-1] Effect of intraoperatively detected bacteriobilia on surgical outcomes after pancreatoduodenectomy: Analysis of a prospective database in a single institute
So Jeong YOON1 , Kyungmin HUH2 , Okjoo LEE1 , Ji Hye JUNG1 , In Woong HAN1 , Jin Seok HEO1 , Dong Wook CHOI3 , Sang Hyun SHIN*1
1 Division Of Hepatobiliary-pancreatic Surgery, Department Of Surgery, Samsung Medical Center, Sungkyunkwan University School Of Medicine, REPUBLIC OF KOREA
2 Division Of Infectious Diseases, Department Of Medicine, Samsung Medical Center, Sungkyunkwan University School Of Medicine, REPUBLIC OF KOREA
3 Department Of General Surgery, Uijeongbu Eulji Medical Center, Eulji University School Of Medicine, REPUBLIC OF KOREA
Background : Bacteriobilia is not uncommon condition in patients undergoing pancreatoduodenectomy (PD). This study aims to investigate the effect of intraoperatively detected bacteriobilia on surgical outcomes after PD.
Methods : For patients who underwent PD in Samsung Medical Center between 2018 and 2020, an intraoperative bile culture was performed prospectively and their clinicopathological data were retrospectively reviewed. Surgical outcomes were compared between the patients, classified according to preoperative biliary drainage (PBD) and bacteriobilia. Logistic regression analysis was performed to identify factors increasing postoperative complications.
Results : Among a total of 382 patients, bacteriobilia was more common in PBD group comparing to non-PBD group (31.1% vs 75.2%, P < .001) but there was no difference in postoperative complications. Among PBD group, there were more patients with major complications and CR-POPF in endoscopic drainage group comparing to percutaneous drainage group (37.9% vs 14.6%, P = .002; 17.0% vs 4.2%, P = .025, respectively). In multivariable analysis, bacteriobilia increased the risk of wound complications (P = .041), but not the risks of other adverse outcomes.
Conclusions : Bacteriobilia itself does not exacerbate short-term postoperative outcomes after PD except for wound complication. Therefore, surgery could be performed as planned regardless of bacteriobilia, without the need to wait for negative cultures.
Methods : For patients who underwent PD in Samsung Medical Center between 2018 and 2020, an intraoperative bile culture was performed prospectively and their clinicopathological data were retrospectively reviewed. Surgical outcomes were compared between the patients, classified according to preoperative biliary drainage (PBD) and bacteriobilia. Logistic regression analysis was performed to identify factors increasing postoperative complications.
Results : Among a total of 382 patients, bacteriobilia was more common in PBD group comparing to non-PBD group (31.1% vs 75.2%, P < .001) but there was no difference in postoperative complications. Among PBD group, there were more patients with major complications and CR-POPF in endoscopic drainage group comparing to percutaneous drainage group (37.9% vs 14.6%, P = .002; 17.0% vs 4.2%, P = .025, respectively). In multivariable analysis, bacteriobilia increased the risk of wound complications (P = .041), but not the risks of other adverse outcomes.
Conclusions : Bacteriobilia itself does not exacerbate short-term postoperative outcomes after PD except for wound complication. Therefore, surgery could be performed as planned regardless of bacteriobilia, without the need to wait for negative cultures.
SESSION
BP Poster Presentation 8
Poster Presentation 3/4/2022 3:20 PM - 4:20 PM