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Effect of Intraoperatively Detected Bacteriobilia on Surgical Outcomes After Pancreatoduodenectomy: Analysis of a Prospective Database in a Single Institute

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Background

Bacteriobilia, the colonization of bacteria in bile, can be caused by obstructive cholangitis or preoperative biliary drainage (PBD), and is not uncommon condition in patients undergoing pancreatoduodenectomy (PD). This study aims to investigate the effect of intraoperatively detected bacteriobilia on surgical outcomes after PD.

Methods

For patients who underwent PD in Samsung Medical Center between 2018 and 2020, an intraoperative bile culture was performed prospectively, and their clinicopathological data were retrospectively reviewed. Surgical outcomes were compared between the patients, classified according to PBD and bacteriobilia. Logistic regression analysis was performed to identify factors increasing postoperative complications.

Results

A total of 382 patients were included, and 202 (52.9%) patients had PBD (PBD group). Bacteriobilia was significantly more common in PBD group comparing to non-PBD group (31.1% vs 75.2%, P < 0.001), but there was no difference in postoperative complications. Among PBD group, there were more patients with major complications and CR-POPF in endoscopic drainage group comparing to percutaneous drainage group (37.9% vs 14.6%, P = 0.002; 17.0% vs 4.2%, P = 0.025, respectively). In multivariable analysis, bacteriobilia increased the risk of wound complications (P = 0.041), but not the risks of other short-term adverse outcomes.

Conclusion

Bacteriobilia itself does not exacerbate short-term postoperative outcomes after PD except for wound complication. Therefore, surgery could be performed as planned regardless of bacteriobilia, without the need to wait for negative cultures.

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Acknowledgements

The authors would like to thank Hyemin Kim (data manager, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) for the help with the data collection.

Funding

This study was supported by a Korean government grant funded by the National Research Foundation of Korea (Ministry of Science and ICT) (NRF-2019R1F1A1042156). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Authors and Affiliations

  1. Division of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea

    So Jeong Yoon, Okjoo Lee, Ji Hye Jung, In Woong Han, Jin Seok Heo & Sang Hyun Shin

  2. Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

    Kyungmin Huh

  3. Department of General Surgery, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu, South Korea

    Dong Wook Choi

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  1. So Jeong Yoon
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Contributions

So Jeong Yoon: Conceptualization, data curation, formal analysis, methodology, writing–original draft, and writing–review and editing.

Kyungmin Huh: Conceptualization, data curation, formal analysis, methodology, and writing–review and editing.

Okjoo Lee: Formal analysis and writing–review and editing.

Ji Hye Jung: Formal analysis and writing–review and editing.

In Woong Han: Conceptualization, data curation, formal analysis, and writing–review and editing.

Jin Seok Heo: Conceptualization, data curation, formal analysis, and writing–review and editing.

Dong Wook Choi: Conceptualization, data curation, formal analysis, and writing–review and editing.

Sang Hyun Shin: Conceptualization, data curation, formal analysis, methodology, writing–original draft, and writing–review and editing.

Corresponding author

Correspondence to Sang Hyun Shin.

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Yoon, S.J., Huh, K., Lee, O. et al. Effect of Intraoperatively Detected Bacteriobilia on Surgical Outcomes After Pancreatoduodenectomy: Analysis of a Prospective Database in a Single Institute. J Gastrointest Surg 26, 2158–2166 (2022). https://doi.org/10.1007/s11605-022-05405-x

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  • DOI: https://doi.org/10.1007/s11605-022-05405-x

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