背景:长期阻塞性黄疸(OJ),与可切除的胰腺病理有关,具有许多有害影响,可以通过术前胆道引流(POBD)纠正,以增加术后感染并发症为代价。这项研究的目的是评估POBD对胰腺切除术患者术中胆道培养(IBC)和手术结果的影响。
方法:来自GrooteSchuur医院患者的数据,开普敦,对2008年10月至2019年5月之间的数据进行了分析。人口统计,临床,和结果变量进行了评估,包括围手术期发病率,死亡率,5年生存率。
结果:在128名患者中,69.5%接受POBD。本研究的围手术期总死亡率为8.8%。POBD组围手术期死亡率显著低于非引流组(5.6%vs.25.6%)。POBD患者手术部位感染的发生率较高(55.1%vs.23.1%),来自IBC的多微生物生长,更有可能培养抗性生物。两组的5年生存率相似。
结论:POBD与IBCs上耐药生物的高发生率相关,手术部位感染的发生率很高,手术部位感染的培养物与IBC之间高度相关。
BACKGROUND: Prolonged obstructive jaundice (OJ), associated with resectable pancreatic pathology, has many deleterious effects that are potentially rectifiable by preoperative biliary drainage (POBD) at the cost of increased postoperative infective complications. The aim of this study is to assess the impact of POBD on intraoperative biliary cultures (IBCs) and surgical outcomes in patients undergoing pancreatic resection.
METHODS: Data from patients at Groote Schuur Hospital, Cape Town, between October 2008 and May 2019 were analysed. Demographic, clinical, and outcome variables were evaluated, including perioperative morbidity, mortality, and 5-year survival.
RESULTS: Among 128 patients, 69.5% underwent POBD. The overall perioperative mortality in this study was 8.8%. The POBD group had a significantly lower perioperative mortality rate compared to the non-drainage group (5.6% vs. 25.6%). POBD patients had a higher incidence of surgical site infections (55.1% vs. 23.1%), polymicrobial growth from IBCs and were more likely to culture resistant organisms. Five-year survival was similar in the two groups.
CONCLUSIONS: POBD was associated with a high incidence of resistant organisms on the IBCs, a high incidence of surgical site infections and a high correlation between cultures from the surgical site infection and the IBCs.