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Bacterial Colonization in Resected Lymph Nodes during Pancreatic Surgery: A Pilot Study
Saadet Coşkun Gürçınar1,2, Ibrahim H Gürçınar1,2, Kathrin Rothe3
1Department of Surgery, TUM University Hospital, Klinikum rechts der Isar, School of Medicine, Munich, Germany.
Introduction:
The detection of bacterial colonization in postoperative pancreatic fistula (POPF) fluid has renewed interest in the role of bacterial translocation during pancreatic surgery. In this context, we hypothesized that peripancreatic lymph nodes (PLNs) might similarly harbor bacterial colonization. This study aimed to investigate the presence of bacteria in these lymph nodes, identify factors potentially contributing to their colonization, and assess the clinical significance of these findings.
Methods:
In this observational pilot study, PLNs (station 8a) resected during pancreatic surgery were analyzed for bacterial DNA using 16S rDNA-PCR, and the microbiological findings were correlated with detailed perioperative and postoperative clinical data.
Results:
Between 2019 and 2026, lymph node station 8a was resected and analyzed in 37 patients undergoing pancreatic surgery. Bacterial colonization was found in 3 patients (8.1%). No significant association was observed between lymph node colonization and the type of surgical procedure, histopathological diagnosis, or the development of clinically relevant POPF or other major postoperative complications. All cases with bacterial colonization had undergone preoperative endoscopic retrograde cholangiopancreatography (ERCP; p = 0.230).
Conclusion:
In this pilot study, bacterial colonization of PLNs was uncommon and was observed only in patients with a history of ERCP. Although no association with POPF was identified, a potential relationship with overall postoperative morbidity cannot be ruled out. Further studies with larger patient cohorts are needed to better define the clinical relevance and underlying mechanisms of lymphatic bacterial translocation.
Insights
Bacterial colonization of peripancreatic lymph nodes is uncommon after pancreatic surgery, particularly in patients without prior ERCP. Further research is needed to understand its clinical impact.
Area of Science:
- Surgical Oncology
- Microbiology
- Gastroenterology
Background:
- Bacterial translocation is a concern in pancreatic surgery.
- Peripancreatic lymph nodes may harbor bacteria.
- Investigating lymph node colonization is crucial for understanding surgical outcomes.
Purpose of the Study:
- To investigate bacterial presence in peripancreatic lymph nodes.
- To identify factors associated with lymph node colonization.
- To assess the clinical significance of bacterial findings in lymph nodes.
Main Methods:
- Observational pilot study analyzing resected peripancreatic lymph nodes (station 8a).
- Bacterial DNA detection using 16S rDNA-PCR.
- Correlation of microbiological findings with clinical data.
Main Results:
- Bacterial colonization found in 8.1% of patients (3/37).
- No significant association with surgical type, pathology, or complications like POPF.
- All positive cases had prior ERCP, though not statistically significant (p=0.230).
Conclusions:
- Peripancreatic lymph node colonization is infrequent.
- ERCP history may be linked to colonization.
- Further studies are required to clarify clinical relevance and mechanisms.
