Rising Incidence of Peri-Operative Bactibilia among Patients Undergoing Complex Biliopancreatic Surgery

Area of Science:

• Gastroenterology
• Surgical Infections
• Microbiology

Background:

• Biliary instrumentation is linked to bactibilia and post-operative infections.
• The temporal incidence of bactibilia remains largely unknown.
• Understanding these trends is crucial for improving patient outcomes.

Purpose of the Study:

• To investigate the incidence of bactibilia over time in patients undergoing bilioenteric anastomosis.
• To evaluate the association between intra-operative bactibilia and post-operative infections.
• To identify trends in culture-positive bile and subsequent infections.

Main Methods:

• A retrospective analysis of consecutive patients undergoing bilioenteric anastomosis surgery from 2008-2019.
• Intra-operative bile duct cultures were assessed for bacterial growth.
• Patients were monitored for post-operative infections, and cultures were compared.

Main Results:

• The frequency of culture-positive intra-operative bile significantly increased over the study period (3.6% to 69.2%; p < 0.001).
• Post-operative infection occurred in 16.8% of patients and was not significantly associated with intra-operative bactibilia (p = 0.552).
• In 35.3% of infected patients, the same microorganism was found in both intra-operative bile and post-operative infection cultures.

Conclusions:

• There has been a notable increase in bactibilia and culture-positive post-operative infections over the past decade.
• While a portion of patients with bactibilia developed infections with the same organism, a definitive causal link remains elusive.
• Further research is needed to elucidate the relationship between bile colonization and post-operative infectious complications.