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Bacterial content of the human pancreatic duct: An observational study

Elke Demir1, Bengi Su Yilmaz1,2, Carsten Jäger1

  • 1Department of Surgery, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany.

Heliyon
|December 5, 2022
PubMed
Abstract

Insights

The human pancreatic duct is typically sterile. Bacterial colonization within the pancreatic duct does not correlate with pancreatic fistula (PF) development, necessitating further research into PF infection mechanisms.

Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Microbiology

Background:

  • Pancreatic fistula (PF) is a significant post-surgical complication.
  • Intestinal bacteria, including Enterobacterales, have been found in PF fluid after distal pancreatectomy (DP).
  • The bacterial flora within the human pancreatic duct remains under-investigated.

Purpose of the Study:

  • To investigate the bacterial flora of the human pancreatic duct in patients undergoing pancreatic surgery.
  • To determine if pancreatic duct bacterial colonization correlates with PF development or other clinical factors.

Main Methods:

  • An observational study involving 54 patients undergoing pancreatico-duodenectomy (PD) or DP between February 2017 and February 2020.
  • Intraoperative swabs were collected from the main pancreatic duct during pancreatic transection.
  • Microbial content was analyzed and correlated with clinical characteristics, PF fluid, bile, and postoperative outcomes.

Main Results:

  • The pancreatic duct swabs were sterile in 72.2% of cases.
  • Intestinal bacteria were detected in 18.5% of swabs, and other bacteria in 9.3%.
  • Preoperative ERCP significantly increased the frequency of pancreatic duct bacterial colonization (33.3% vs. 6.7%, p=0.005).
  • No correlation was found between pancreatic duct microbial content and PF fluid, bile bacteria, or postoperative complications.

Conclusions:

  • The human main pancreatic duct is generally sterile.
  • Bacterial colonization of the pancreatic duct does not appear to be a predictor of pancreatic fistula.
  • Further mechanistic studies are required to understand the pathogenesis of pancreatic fistula infections.
Keywords:
BacteriaComplicationsEnterobacteralesFistulaPancreatic ductPancreatic surgery

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