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首页> 外文期刊>World Journal of Surgery: Official Journal of the Societe Internationale de Chirurgie, Collegium Internationale Chirurgiae Digestivae, and of the International Association of Endocrine Surgeons >Specific antibiotic prophylaxis based on bile cultures is required to prevent postoperative infectious complications in pancreatoduodenectomy patients who have undergone preoperative biliary drainage.
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Specific antibiotic prophylaxis based on bile cultures is required to prevent postoperative infectious complications in pancreatoduodenectomy patients who have undergone preoperative biliary drainage.

机译：在胆道十二指肠切除术的术前胆道引流患者中，需要采取基于胆汁培养的特殊抗生素预防措施来预防术后感染并发症。

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BACKGROUND: Preoperative biliary drainage (PBD) is associated with bacterial contamination of bile, but the effects of PBD on morbidity after pancreatoduodenectomy remain controversial. The aim of this study was to characterize bile contamination to develop successful specific antibiotic prophylactic strategies for pancreatoduodenectomy. METHODS: Ninety-one consecutive patients who underwent pancreatoduodenectomy for periampullary tumor were prospectively evaluated. Prophylactic antibiotics were selected based on preoperative bile cultures. Bile cultures and postoperative complications were compared in 46 patients who underwent PBD (drainage group) versus 45 patients who did not (nondrainage group). RESULTS: The incidence of positive bile cultures was higher in the drainage group (78%) than in the nondrainage group (36%) (P < 0.001). In the drainage group, positive bile cultures were frequently polymicrobial (61%) and demonstrated resistance to several antibiotics, including cefazolin (83%), cefmetazole (72%), and cefpirome (64%). Overall morbidity (30% and 22%) and infectious morbidity (13% and 11%) did not differ significantly between the drainage and nondrainage groups, respectively. CONCLUSIONS: PBD had a notable influence on bile microbial contamination, including a higher rate of antibiotic resistance. Therefore, specific antibiotic prophylaxis based on bile culture is required for preventing infectious complications in pancreatoduodenectomy patients who undergo PBD.
机译：背景：术前胆道引流（PBD）与胆汁细菌污染有关，但PBD对胰十二指肠切除术后发病率的影响仍存在争议。这项研究的目的是表征胆汁污染，以开发成功的胰腺十二指肠切除术的特殊抗生素预防策略。方法：前瞻性评估了连续接受胰腺胰十二指肠切除术的壶腹周围肿瘤的91例患者。根据术前胆汁培养选择预防性抗生素。比较了46例行PBD的患者（引流组）和45例未行PBD的患者（不引流组）的胆汁培养和术后并发症。结果：引流组胆汁培养阳性的发生率（78％）高于不引流组（36％）（P <0.001）。在引流组中，阳性胆汁培养物经常是微生物（61％），并且显示出对几种抗生素的抗性，包括头孢唑林（83％），头孢甲唑（72％）和头孢哌隆（64％）。引流组和不引流组的总发病率（30％和22％）和传染病率（13％和11％）没有显着差异。结论：PBD对胆汁微生物污染有显着影响，包括更高的抗生素耐药率。因此，需要基于胆汁培养的特定抗生素预防措施，以预防接受PBD的胰十二指肠切除术患者的感染并发症。

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