1. Effect of preoperative biliary drainage for obstructive jaundice on postoperative course after pancreaticoduodenectomy
- Author
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Jashkaran Singh, Arunanshu Behera, Vishal Attri, Lileswar Kaman, and Divya Dahiya
- Subjects
Biliary drainage ,medicine.medical_specialty ,Hepatology ,business.industry ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Incidence (epidemiology) ,Gastroenterology ,Cefazolin ,Stent ,Perioperative ,Pancreaticoduodenectomy ,Internal medicine ,medicine ,In patient ,Obstructive jaundice ,business ,medicine.drug - Abstract
s / Pancreatolog S108 Aims: Definition of an alternative prophylaxis targeted on bile cultures in pancreatic surgery and validation of SSIs incidence. Patients & methods: Between Jan-2010 and Oct-2013 we performed 222 consecutive pancreatic resections with bile contamination (203 pancreaticoduodenectomies, 19 total pancreatectomies). We routinely performed culture on intra-operative bile samples and prospectively recorded SSIs. Analyzing antimicrobial susceptibility of detected germs, we introduced from Mar-2013 ampicillin-sulbactam as alternative to cefazolin for perioperative prophylaxis; we therefore realized a comparison between patients receiving standard (n1⁄4170) and new (n1⁄452) schedule. Results: Analyzing the standard group, 56% of patients had positive bile cultures; 49% of microbes belonged to Enterococcus Spp. 47% of patients had a preoperative biliary stent: it was strongly associated with bile infection (100% vs 17%, p
- Published
- 2014