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Effect of acid-suppressive drugs on endoscopic transmural drainage of peripancreatic fluid collections-a randomized
Yaoting Li1, Tingting Yu1, Senlin Hou1
1Biliary Pancreatic Endoscopic Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
Background:
Acid-suppressing drugs affect intestinal microbes by inhibiting the secretion of stomach acid. However, it is not clear whether acid suppressive drugs affect the microorganisms in the peripancreatic effusion and affect the postoperative complications.
Methods:
This study was a prospective randomized controlled trial. A total of 45 patients were enrolled in the trial, and all patients were divided into acid-inhibited and non-inhibited groups. The primary endpoint of our study was to observe the difference in microbiota between the two groups of cyst fluid.
Results:
A total of 25 patients were included in the acid-inhibited group, and 20 patients were included in the non-acid-inhibited group. There were no significant differences between the two groups in terms of postoperative infection, bleeding, and recurrence rates (p > 0.05). In terms of postoperative C-reactive protein levels, the acid-suppressing group was significantly higher than the non-acid-suppressing group (p < 0.05). In the 16S microbial sequencing analysis, we found no significant difference in α diversity between the acid-suppressing group and the non-acid-suppressing group, but there was a statistically significant difference in β diversity between the two groups.
Conclusion:
Acid-suppressing drugs can change the microbial composition of pancreatic effusions and increase markers of postoperative inflammation. Acid-suppressive drugs may increase the risk of infection after endoscopic drainage.
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