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Impact of perioperative symbiotic therapy on infectious morbidity after Hpb Surgery in jaundiced patients: a randomized controlled trial

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Abstract

This study aimed at evaluating whether the administration of symbiotic therapy in jaundiced patients could reduce their postoperative infectious complications. The study was conducted between November 2008 and February 2011. Jaundiced patients scheduled for elective extrahepatic bile duct resection without liver cirrhosis, intestinal malabsorption or intolerance to symbiotic therapy were randomly assigned to receive [Group A] or not [Group B] symbiotics perioperatively. The primary endpoint was the infectious morbidity rate. Forty patients were included in the analysis (20 in each group). The patients in Group B presented a higher overall morbidity (70 vs 50 %) and infectious morbidity rate (50 vs 25 %), but the differences were not significant. Eleven patients in Group A (Group ndA) and 13 in Group B (Group ndB) did not receive preoperative biliary drainage. The results of the two groups were comparable. Infectious complications were higher in Group B [5 (34 %) vs 0, p = 0.030], while the prevalence of natural killer (NK) cells was higher in Group ndA the day before surgery (17 % ± 5.1 vs 10 % ± 5.3, p < 0.01) and on post-operative day (POD) 7 (13.1 % ± 4.1 vs 7.7 % ± 3.4, p < 0.01). The rates of lymph node colonization were similar. The symbiotic therapy failed to reduce the rate of infectious morbidity in jaundiced patients. Further studies investigating the place of symbiotic in no-drainage patients are required.

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Acknowledgments

The authors are grateful to nursing staff who participated in the study, especially to Mr. Antonio Valenti for his help.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of General and Oncological Surgery, ‘Umberto I’ Mauriziano Hospital, Largo Turati, 62-10128, Turin, Italy

    N. Russolillo, A. Ferrero, L. Vigano’, S. Langella & L. Capussotti

  2. Department of Internal Medicine, Infectivology, ‘Umberto I’ Mauriziano Hospital, Turin, Italy

    A. Briozzo

  3. Department of Clinical Pathology, ‘Umberto I’ Mauriziano Hospital, Turin, Italy

    M. Ferlini & M. Migliardi

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  1. N. Russolillo
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  2. A. Ferrero
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  3. L. Vigano’
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  4. S. Langella
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  5. A. Briozzo
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  6. M. Ferlini
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  8. L. Capussotti
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Correspondence to N. Russolillo.

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Russolillo, N., Ferrero, A., Vigano’, L. et al. Impact of perioperative symbiotic therapy on infectious morbidity after Hpb Surgery in jaundiced patients: a randomized controlled trial. Updates Surg 66, 203–210 (2014). https://doi.org/10.1007/s13304-014-0259-y

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  • DOI: https://doi.org/10.1007/s13304-014-0259-y

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