Ng Zi Qin, Suthananthan Arul Edward, Rao Sudhakar
Department of General Surgery, Royal Perth Hospital, Perth, Western Australia, Australia.
Ann Hepatobiliary Pancreat Surg. 2017 Nov;21(4):212-216. doi: 10.14701/ahbps.2017.21.4.212. Epub 2017 Nov 30.
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.
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.
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.
Preoperative biliary drainage prior to pancreaticoduodenectomy increases risk of developing post-operative wound infections and intra-abdominal collections.
背景/目的：术前胆道支架置入术（PBS）对接受胰十二指肠切除术患者术后感染性并发症的影响尚不清楚。因此，本研究的目的是探讨PBS与术后感染性并发症之间的关系，确定PBS对胆汁细菌学的影响，并将我院胆汁细菌学与术后感染性并发症培养出的细菌进行关联分析。
回顾了2011年1月至2015年4月期间51例行胰十二指肠切除术患者的详细资料。51例患者中，30例接受了术前胆道支架置入术（PBS组），21例未接受术前胆道支架置入术直接行胰十二指肠切除术。比较两组术后感染性并发症情况。
PBS组和非PBS组术后总体感染性并发症发生率分别为77%和67%。伤口感染是主要的感染性并发症，其次是腹腔内脓肿。PBS组伤口感染率翻倍（50%对28%）。PBS组腹腔内脓肿发生率略有增加（53%对46%）。PBS组80%的患者术中胆汁培养阳性，而非PBS组为20%。
胰十二指肠切除术前行术前胆道引流会增加术后伤口感染和腹腔内积液的发生风险。
