Related Experiment Video
Updated: Jan 7, 2026
Author Spotlight: Advancements in Retroperitoneal Approach for Necrotizing Pancreatitis
Published on: March 15, 2024
Prolonged Prophylactic Antibiotics Based on Preoperative Bile Culture Reduce Surgical Site Infections After
Kyohei Matsumoto1, Atsushi Shimizu1, Yuji Kitahata1
1Second Department of Surgery, School of Medicine Wakayama Medical University Wakayama Japan.
Objective:
The optimum duration of prophylactic antibiotics after pancreaticoduodenectomy following preoperative biliary drainage to prevent surgical site infections remains controversial. We evaluate whether a prolonged course of prophylactic antibiotics reduces surgical site infection after pancreaticoduodenectomy following biliary drainage more than that within the standard duration.
Methods:
We enrolled 352 consecutive patients from one hospital who underwent pancreaticoduodenectomy following biliary drainage between 2010 and 2023. The patients were prospectively assigned to two groups according to prophylactic antibiotic duration. In the standard duration group (2010-2013; 112 patients), the duration was within 24 h postoperatively. In the prolonged duration group (2014-2023; 240 patients), it was 3 days postoperatively. The primary endpoint was the incidence of surgical site infection between these groups. We performed 1:1 propensity score matching to balance baseline characteristics, which yielded 77 patients per group.
Results:
There was significantly less surgical site infection in the longer duration group (13%) than in the standard duration group (29%) (p = 0.0010). After matching, the prolonged duration group maintained significantly lower rates of all surgical site infection (32% vs. 14%, p = 0.0126), organ/space surgical site infection (27% vs. 13%, p = 0.0433), incisional surgical site infection (18% vs. 3%, p = 0.0026), superficial incisional surgical site infection (13% vs. 3%, p = 0.0314). In the multivariate analysis, independent risk factors for surgical site infection after pancreaticoduodenectomy following biliary drainage were elevated drain fluid amylase on postoperative day 1 (p < 0.0001) and 1-day prophylactic antibiotics (p = 0.00012).
Conclusions:
Prolonged prophylactic antibiotics significantly reduced surgical site infection incidence after pancreaticoduodenectomy in patients undergoing preoperative biliary drainage.
More Related Videos
05:36Laparoscopic Common Bile Duct Exploration Followed by Primary Suture Using a Modified Bile Duct Incision
Published on: May 2, 2025
14:56Application of Indocyanine Green Fluorescence Imaging Technology in Laparoscopic Duodenum-Preserving Pancreatic Head Resection
Published on: November 21, 2025
Related Concept Videos
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
01:29Chronic Pancreatitis II: Collaborative Care
Assessment:
01:29Appendicitis-II: Diagnostic Studies and Management
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
01:26Endoscopic Procedures V: ERCP
Patient...