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Effect of preoperative biliary stenting on post-operative infectious complications in pancreaticoduodenectomy
Ann Hepatobiliary Pancreat Surg 2017 Nov;21(4):212-6
Published online November 30, 2017
Copyright © 2017 Ann Hepatobiliary Pancreat Surg.

Zi Qin Ng, Arul Edward Suthananthan, and Sudhakar Rao

Department of General Surgery, Royal Perth Hospital, Perth, Western Australia, Australia
Received April 26, 2017; Revised June 27, 2017; Accepted July 7, 2017.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Backgrounds/Aims: The impact of pre-operative biliary stenting (PBS) in patients undergoing pancreaticoduodenectomy on post-operative infectious complications is unclear. Therefore, the purpose of this study is to investigate the relationship between PBS and post-operative infectious complications, to determine the effect of PBS on bile bacteriology, and to correlate the bacteriology of bile and bacteria cultured from post-operative infectious complications in our institute. Methods: Details of 51 patients undergoing pancreaticoduodenectomy January 2011-April 2015 were reviewed. Of 51 patients, 30 patients underwent pre-operative biliary stenting (PBS group) and 21 patients underwent pancreaticoduodenectomy without pre-operative biliary stenting. Post-operative infectious complications were compared between the two groups. Results: Overall post-operative infectious complication rate was 77% and 67% in the PBS and non-PBS groups respectively. Wound infection was the main infectious complication followed by intraabdominal abscess. The rate of wound infection doubled in the PBS group (50% vs 28%). There was slight increase in incidence of intraabdominal abscess in PBS group (53% vs 46%). 80% of PBS patients had positive intraoperative bile culture as compared to 20% in non-PBS group. Conclusions: Preoperative biliary drainage prior to pancreaticoduodenectomy increases risk of developing post-operative wound infections and intra-abdominal collections. (Ann Hepatobiliary Pancreat Surg 2017;21:212-216)
Keywords : Infection; Intra-abdominal abscess; Pancreaticoduodenectomy; Stent; Wound