1. Does Fungal Biliary Contamination after Preoperative Biliary Drainage Increase Postoperative Complications after Pancreaticoduodenectomy?
- Author
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Tortajada, Pauline, Sauvanet, Alain, Truant, Stephanie, Regenet, Nicolas, Souche, Régis, Benoist, Stéphane, Muscari, Fabrice, Regimbeau, Jean, Gaujoux, Sebastien, Cunha, Antonio, Schwarz, Lillian, Group, FRENCH-ACHBT Working, Service de chirurgie digestive [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Hôpital Beaujon, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Claude Huriez [Lille], CHU Lille, Centre hospitalier universitaire de Nantes (CHU Nantes), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Université de Montpellier (UM), Service de Chirurgie générale et digestive [CHU Le Kremlin-Bicêtre], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Hôpital de Rangueil, CHU Toulouse [Toulouse], Chirurgie digestive [CHU Amiens], CHU Amiens-Picardie, Chirurgie digestive, hépato-biliaire et endocrinienne [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris], Centre Hépato-Biliaire [Hôpital Paul Brousse] (CHB), and Hôpital Paul Brousse-Assistance Publique - Hôpitaux de Paris
- Subjects
Cancer Research ,medicine.medical_specialty ,medicine.medical_treatment ,Fungal contamination ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,[SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery ,lcsh:RC254-282 ,Gastroenterology ,Article ,03 medical and health sciences ,0302 clinical medicine ,infectious complications ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Infectious complication ,Internal medicine ,medicine ,Complication rate ,Biliary drainage ,business.industry ,biliary contamination ,fungal infection ,[SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology ,Retrospective cohort study ,Contamination ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Pancreaticoduodenectomy ,3. Good health ,biliary drainage ,Oncology ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,pancreaticoduodenectomy ,business - Abstract
(1) Background: preoperative biliary drainage before pancreaticoduodenectomy (PD) is associated with bacterial biliary contamination (>, 85%) and a significant increase in global and infectious complications. In view of the lack of published data, the aim of our study was to investigate the impact of fungal biliary contamination after biliary drainage on the complication rate after PD. (2) Methods: a multicentric retrospective study that included 224 patients who underwent PD after biliary drainage with intraoperative biliary culture. (3) Results: the global rate of positive intraoperative biliary sample was 92%. Respectively, the global rate of biliary bacterial contamination and the rate of fungal contamination were 75% and 25%, making it possible to identify two subgroups: bacterial contamination only (B+, n = 154), and bacterial and fungal contamination (BF+, n = 52). An extended duration of preoperative drainage (62 vs. 49 days, p = 0.08) increased the risk of fungal contamination. The overall and infectious complication rates were not different between the two groups. In the event of postoperative infectious or surgical complications, the infectious samples taken did not reveal more fungal infections in the BF+ group. (4) Conclusions: fungal biliary contamination, although frequent, does not seem to increase the rate of global and infectious complications after PD, preceded by preoperative biliary drainage.
- Published
- 2020
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