Medizinische Universität Graz - Research portal
Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Cammann, S; Timrott, K; Vonberg, RP; Vondran, FW; Schrem, H; Suerbaum, S; Klempnauer, J; Bektas, H; Kleine, M.
Cholangitis in the postoperative course after biliodigestive anastomosis.
Langenbecks Arch Surg. 2016; 401(5): 715-724.
Doi: 10.1007/s00423-016-1450-z
Web of Science
PubMed
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- Co-authors Med Uni Graz
- Schrem Harald Heinrich
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- Abstract:
- Hepatobiliary surgery with biliodigestive anastomosis (BDA) results in a loss of the sphincter of Oddi with consecutive ascension of bacteria into the bile system which may cause cholangitis in the postoperative course. Patients who received reconstruction with a BDA after hepatobiliary surgery were analyzed retrospectively for their postoperative course of disease depending on intraoperatively obtained bile cultures and antibiotic prophylaxis. Two hundred forty-three patients were included in the analysis, 49.4 % of whom had received endoscopic stenting before the operation. Stenting was significantly associated with the presence of drug-resistant bacteria in the intraoperatively obtained bile sample (p < 0.001, OR = 4.09). Of all patients, 14.4 % developed postoperative cholangitis. This was significantly associated with the postoperative length of stay in the intensive care unit (p = 0.002, OR = 1.035). The highest incidence of postoperative cholangitis was found in patients with cholangiocellular carcinoma (n = 12, p = 0.046, OR = 2.178). Patients were more likely to harbor strains with resistance against the antibiotic that was given intraoperatively. The risk for the presence of drug-resistant bacteria is increased by preoperative stenting of the common bile duct. Bile culture by intraoperative swabs can be altered by the perioperative antibiotic prophylaxis as it induces microbiological selection in the common bile duct.
- Find related publications in this database (using NLM MeSH Indexing)
- Adult -
- Aged -
- Aged, 80 and over -
- Anastomosis, Surgical - adverse effects
- Antibiotic Prophylaxis -
- Bile -
- Bile Duct Neoplasms - surgery
- Cholangitis - etiology
- Cholangitis - prevention & control
- Drug Resistance, Bacterial -
- Female -
- Humans -
- Length of Stay -
- Male -
- Middle Aged -
- Pancreatic Neoplasms - surgery
- Postoperative Complications - etiology
- Postoperative Complications - microbiology
- Postoperative Complications - prevention & control
- Retrospective Studies -
- Stents - adverse effects
- Young Adult -
- Find related publications in this database (Keywords)
- Biliodigestive anastomosis
- Postoperative cholangitis
- Pancreatic carcinoma
- Bile duct cancer
- Antibiotic treatment