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Pyogenic Liver Abscess After Pancreaticoduodenectomy: A Single-Center Experience

Wen Chen1, Tao Ma1, Xueli Bai1

  • 1Department of Hepatobiliary and Pancreatic Surgery, Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang Provincial Key Laboratory of Pancreatic Disease, Hangzhou, China.

The Journal of Surgical Research
|March 1, 2019
PubMed
Abstract

Insights

Patients with diabetes have a higher risk of developing pyogenic liver abscess (PLA) after pancreaticoduodenectomy (PD). Multiple abscesses were common, and Klebsiella pneumoniae should be considered in empirical treatment for PLA post-PD.

Area of Science:

  • Gastroenterology
  • Hepatology
  • Infectious Diseases

Background:

  • Pancreaticoduodenectomy (PD) is a major surgical procedure with significant morbidity.
  • Pyogenic liver abscess (PLA) is a rare but serious infectious complication following PD.

Purpose of the Study:

  • To investigate the incidence, risk factors, and outcomes of PLA after PD.
  • To compare PLA characteristics in PD patients with those without a history of abdominal surgery.

Main Methods:

  • Retrospective analysis of 326 patients undergoing PD.
  • Matching PLA patients (n=11) with controls (n=33) and comparing with PLA patients without prior surgery (n=77).

Main Results:

  • PLA occurred in 3.4% of PD patients.
  • Diabetes significantly increased PLA risk (45.5% vs 12.1%).
  • Higher preoperative and postoperative fasting blood glucose levels were observed in PLA patients.

Conclusions:

  • Diabetes is a risk factor for PLA after PD.
  • Multiple liver abscesses are common in PD patients.
  • Empirical treatment for PLA should include coverage for Klebsiella pneumoniae.
Keywords:
DiabetesKlebsiella pneumoniaePancreaticoduodenectomyPyogenic liver abscess

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