Microbiology and complications in duodenopancreatectomy: the implications of pre-operative ERCP

Abstract

Objective: Patients undergoing pancreatoduodenectomy at the clinics hospital of the University of Sao Paulo between January/2009 and September/2014 were retrospectively reviewed. Methods: We evaluated etiology and the impact of bile culture positivity on development of post-operative complications. Patients were divided into groups according to results of intraoperative bile culture and ECRP with prosthesis before the surgery. Results: There were 114 patients submitted to pancreatoduodenectomy in the period. In 62 (54.4%) intraoperative bile cultures were positive. The most frequent bacteria found was Enteroccocus sp. The average BMI and age were similar in both groups (25.14 positive culture×25.78 negative cultures) and (62.2×54.1). Length of hospital stay (LOS) (12.78 positive culture group×12.73 negative culture group) and surgical time were also similar (304.2×54.10). Postoperative complications were identified in 52.6% of cases (46.8 % in the positive culture group and 57.8 % in the negative culture group). ERCP was done in 58.1% of the patients with positive bile culture: 90.1% had plastic prosthesis against 7% of metallic prosthesis (2.8% didn't have any prosthesis). Conclusion: According to our data, pre-operative biliary drainage was associated with positive biliary culture. Both groups were similar regarding age and BMI. However, there were no differences regarding post-operative complications, LOS and surgical time.