Publication:
Surgical site infections after pancreaticoduodenectomy: preoperative biliary system interventions and antimicrobial prophylaxis

dc.contributor.coauthorBilgiç, Ç.
dc.contributor.coauthorKeske, Ş.
dc.contributor.coauthorSobutay, E.
dc.contributor.coauthorCan, U.
dc.contributor.coauthorZenger, S.
dc.contributor.coauthorGürbüz, B.
dc.contributor.kuauthorErgönül, Önder
dc.contributor.kuauthorBilge, Orhan
dc.contributor.kuprofileFaculty Member
dc.contributor.kuprofileFaculty Member
dc.contributor.yokid110398
dc.contributor.yokid176833
dc.date.accessioned2024-11-09T11:50:51Z
dc.date.issued2020
dc.description.abstractBackground: The rate of surgical site infection (SSI) after pancreaticoduodenectomy (PD) is high and insertion of preoperative bile duct catheterization (PBDC) predispose a high risk of SSI with multidrug resistant (MDR) microorganisms. Aim: To describe the effects of PBDC and the prophylaxis in development of SSI. Methods: We conducted a retrospective study between January 01, 2010 and December 2018 including the patients with PD and total pancreatectomy. Findings: In total 214 consecutive patients were included. The PBDC was inserted to 63 (29%) patients. The rate of intraoperative bile fluid culture positivity was higher among the patients with PBDC (84% vs. 17% respectively, p < 0.001). The SSI was detected in 52 patients (24%). In multivariate analysis, the rate of SSI was found to be higher among the patients with PBDC (OR: 2.33, 95% Cl: 1.14–4.76, p = 0.02). As the etiologic agents of SSI, Pseudomonas spp. and MDR pathogens were mainly detected in PBDC group. The resistance to ampicillin-sulbactam was significantly higher in the PBDC group (87.5% vs. 25%, p = 0.012). The similar bacterial species both in bile fluid and the surgical site were detected in 11 (21%) patients with SSI. Among 8 patients (15%), antimicrobial susceptibility was the same. Only in five out of 52 (10%) patients, the SSI pathogens was susceptible to the agent that was used for surgical prophylaxis. Conclusion: Unnecessary catheterizations should be avoided. By considering the increasing prevalence of resistant bacteria as the cause of SSI, the clinicians should closely follow-up their patients for choosing the proper antimicrobials.
dc.description.fulltextYES
dc.description.indexedbyScopus
dc.description.indexedbyPubMed
dc.description.openaccessYES
dc.description.publisherscopeInternational
dc.description.sponsoredbyTubitakEuN/A
dc.description.sponsorshipN/A
dc.description.versionPublisher version
dc.description.volume95
dc.formatpdf
dc.identifier.doi10.1016/j.ijid.2020.04.005
dc.identifier.embargoNO
dc.identifier.filenameinventorynoIR02179
dc.identifier.issn1201-9712
dc.identifier.linkhttps://doi.org/10.1016/j.ijid.2020.04.005
dc.identifier.quartileQ1
dc.identifier.scopus2-s2.0-85083889091
dc.identifier.urihttps://hdl.handle.net/20.500.14288/692
dc.keywordsPancreaticoduodenectomy
dc.keywordsPreoperative biliary system interventions
dc.keywordsSurgical prophylaxis
dc.keywordsSurgical site infections
dc.languageEnglish
dc.publisherElsevier
dc.relation.grantnoNA
dc.relation.urihttp://cdm21054.contentdm.oclc.org/cdm/ref/collection/IR/id/8831
dc.sourceInternational Journal of Infectious Diseases
dc.subjectJaundice, obstructive
dc.subjectDrainage
dc.subjectPreoperative biliary
dc.titleSurgical site infections after pancreaticoduodenectomy: preoperative biliary system interventions and antimicrobial prophylaxis
dc.typeJournal Article
dspace.entity.typePublication
local.contributor.authorid0000-0003-1935-9235
local.contributor.authorid0000-0002-8277-8697
local.contributor.kuauthorErgönül, Mehmet Önder
local.contributor.kuauthorBilge, Orhan
local.publication.orgunit1SCHOOL OF MEDICINE
local.publication.orgunit2School of Medicine

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