Perioperative pancreaticoduodenectomy management strategy focusing on postoperative early drain colonization.
Surg Today
; 54(9): 1067-1074, 2024 Sep.
Article
in En
| MEDLINE
| ID: mdl-38502211
ABSTRACT
PURPOSE:
Pancreatoduodenectomy (PD) is a highly invasive procedure. Intra-abdominal infections and pancreatic fistulas are strongly correlated complications. In the present study, we identified the risk factors for postoperative early drain colonization (POEDC) and established a perioperative management strategy.METHODS:
A total of 205 patients who underwent pancreatoduodenectomy were included in the study. POEDC was defined as a positive drain fluid culture before postoperative day (POD) 4. We retrospectively investigated the correlation between POEDC, postoperative outcomes, and clinical factors.RESULTS:
POEDC was observed in 26 patients (12.6%) with poor postoperative outcomes, including pancreatic fistulas (P < 0.001). A multivariate analysis demonstrated a correlation between these postoperative outcomes and the age (P = 0.002), body mass index (BMI) (P = 0.002), procalcitonin (PCT) level (P < 0.001), and drain amylase level on POD 1 (P = 0.032). Enterococcus was detected most frequently, being found in 15 patients.CONCLUSION:
We observed a strong correlation between POEDC and poor postoperative outcomes. The BMI, age, and PCT and drain amylase level on POD 1 should be considered POEDC risk factors, with the need to propose an antibiotic perioperative strategy. POEDC control may represent the key to improving postoperative outcomes after PD.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Postoperative Complications
/
Body Mass Index
/
Drainage
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Pancreatic Fistula
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Pancreaticoduodenectomy
/
Perioperative Care
Limits:
Adult
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Aged
/
Aged80
/
Female
/
Humans
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Male
/
Middle aged
Language:
En
Journal:
Surg Today
/
Surg. today
/
Surgery today
Year:
2024
Document type:
Article
Affiliation country:
Japón
Country of publication:
Japón