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Does Fungal Biliary Contamination after Preoperative Biliary Drainage Increase Postoperative Complications after

Pauline Tortajada1, Alain Sauvanet2, Stephanie Truant3

  • 1Department of Digestive Surgery, Rouen University Hospital, 1 rue de Germont, F-76031 Rouen, CEDEX, France.

Cancers
|October 3, 2020
PubMed

Insights

Preoperative biliary drainage before pancreaticoduodenectomy (PD) can lead to fungal contamination. However, this study found that fungal contamination does not increase complication rates after PD.

Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Infectious Diseases

Background:

  • Preoperative biliary drainage before pancreaticoduodenectomy (PD) is linked to high rates of bacterial biliary contamination and increased complications.
  • Limited data exists on the impact of fungal biliary contamination following drainage on PD outcomes.
  • This study addresses the knowledge gap regarding fungal contamination and its association with complications after PD.

Purpose of the Study:

  • To investigate the impact of fungal biliary contamination on complication rates after pancreaticoduodenectomy (PD).
  • To analyze the relationship between preoperative biliary drainage duration and fungal contamination risk.

Main Methods:

  • A multicentric retrospective study involving 224 patients undergoing PD after biliary drainage.
  • Intraoperative biliary cultures were performed to assess bacterial and fungal contamination.
  • Patients were categorized into bacterial contamination only (B+) and bacterial and fungal contamination (BF+) groups.

Main Results:

  • The overall rate of positive intraoperative biliary samples was 92%, with 75% bacterial and 25% fungal contamination.
  • Extended preoperative drainage duration (62 vs. 49 days) showed a trend towards increased fungal contamination risk (p=0.08).
  • No significant difference in overall or infectious complication rates was observed between the B+ and BF+ groups.

Conclusions:

  • Fungal biliary contamination is frequent after preoperative biliary drainage but does not appear to elevate complication rates post-PD.
  • The findings suggest that fungal contamination, despite its prevalence, may not be a significant risk factor for adverse outcomes after PD.
Keywords:
biliary contaminationbiliary drainagefungal infectioninfectious complicationspancreaticoduodenectomy

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