| Title: |
Alarming correlation between multidrug-resistant bacteriobilia and morbidity after pancreatic surgery |
| Authors: |
Gibiino G.; Cucchetti A.; Mocchegiani F.; Bocchino A.; Gaudenzi F.; Binda C.; Raumer L.; Fabbri C.; Cristini F.; Vivarelli M.; Ercolani G. |
| Contributors: |
Gibiino, G.; Cucchetti, A.; Mocchegiani, F.; Bocchino, A.; Gaudenzi, F.; Binda, C.; Raumer, L.; Fabbri, C.; Cristini, F.; Vivarelli, M.; Ercolani, G. |
| Publication Year: |
2023 |
| Collection: |
IRIS Università degli Studi di Bologna (CRIS - Current Research Information System) |
| Subject Terms: |
Antibiotic prophylaxi; Biliary drainage; Biliary microbiota; Pancreatic ductal adenocarcinoma |
| Description: |
Background: Pancreatic surgery is characterized by high morbidity and mortality. Biliary colonization may affect clinical outcomes in these patients. Aims: This study aimed to verify whether bacteriobilia and multidrug resistance (MDR) detected during and after pancreatic surgery may have an impact on post-operative outcomes. Methods: Data from patients undergoing pancreatic surgery involving bile duct transection (2016-2022) in two high-volume centers were analyzed in relationship to overall morbidity, major morbidity and mortality after pancreato-duodenectomy (PD) or total pancreatectomy (TP). Simple and multivariable regressions were used. Results: 227 patients submitted to PD (n=129) or TP (n=98) were included. Of them, 133 had preoperative biliary drainage (BD; 56.6%), mostly with the employment of endoscopic stents (91.7%). Bacteriobilia was detected in 111 patients (48.9%), and remarkably, observed in patients with BD (p=0.001). In addition, 25 MDR pathogens were identified (22.5%), with a significant prevalence in patients with BD. Multivariable regression analysis showed BD was strongly related to MDR isolation (odds ratio [OR]: 5.61; p=0.010). MDR isolation was the main factor linked to a higher number of major complications (OR: 2.75; p=0.041), including major infection complications (OR: 2.94; p=0.031). Conclusions: Isolation of MDR from biliary swab during PD or TP significantly increases the risk of a worse post-operative outcome. Pre-operative precautions could improve patient safety. |
| Document Type: |
article in journal/newspaper |
| File Description: |
STAMPA |
| Language: |
English |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/37263811; info:eu-repo/semantics/altIdentifier/wos/WOS:001097320100001; volume:55; issue:11; firstpage:1502; lastpage:1508; numberofpages:7; journal:DIGESTIVE AND LIVER DISEASE; https://hdl.handle.net/11585/961463 |
| DOI: |
10.1016/j.dld.2023.05.012 |
| Availability: |
https://hdl.handle.net/11585/961463; https://doi.org/10.1016/j.dld.2023.05.012 |
| Accession Number: |
edsbas.65AE3141 |
| Database: |
BASE |