Retrospective Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 7, 2019; 25(41): 6238-6247
Published online Nov 7, 2019. doi: 10.3748/wjg.v25.i41.6238
Bacterobilia in pancreatic surgery-conclusions for perioperative antibiotic prophylaxis
Colin Markus Krüger, Ulrich Adam, Thomas Adam, Axel Kramer, Claus D Heidecke, Frank Makowiec, Hartwig Riediger
Colin Markus Krüger, Department of Surgery, Immanuel Hospital Rüdersdorf, Berlin 15562, Germany
Ulrich Adam, Hartwig Riediger, Department of General Surgery, Vivantes-Humboldt hospital, Berlin 13503, Germany
Thomas Adam, Department of Microbiology, Labor Berlin GmbH, Berlin 13353, Germany
Axel Kramer, Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Greifswald 17495, Mecklenburg Vorpommern, Germany
Claus D Heidecke, Department of Surgery, Clinic of General, Visceral, Vascular and Thoracic Surgery, University Medicine Greifswald, Greifswald 17475, Mecklenburg Vorpommern, Germany
Frank Makowiec, Section of clinical risk assessment, University hospital of Freiburg, Freiburg 79106, Baden-Württemberg, Germany
Author contributions: Krueger CM contributed to design of the study, acquisition and analysis of data, and writing of manuscript; Adam U contributed to performing of procedures, acquisition of data, and critical review of manuscript; Adam T contributed to acquisition of data and critical review of manuscript; Kramer A contributed to design of the study, analysis of data, interpretation of data, writing of manuscript, and reviewing the manuscript; Heidecke CD contributed to interpretation of data and critical review of manuscript; Makowiec F contributed to interpretation of data and critical review of manuscript; Riediger H contributed to design of the study, performing of procedures, analysis and interpretation of data, and writing of manuscript.
Institutional review board statement: The study was only reviewed and approved by the Review Board of Brandenburg Medical School.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All authors declare no conflicts-of-interest related to this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Colin Markus Krüger, FACS, MD, PhD, Chief Physician, Postdoc, Surgeon, Department of Surgery, Immanuel Hospital Rüdersdorf, Seebad 82/83, Berlin 15562, Germany. cm.krueger@immanunel.de
Telephone: +49-1718-151480
Received: July 12, 2019
Peer-review started: July 12, 2019
First decision: August 18, 2019
Revised: October 10, 2019
Accepted: October 17, 2019
Article in press: October 17, 2019
Published online: November 7, 2019
Core Tip

Core tip: The aim of our retrospective study was to analyze the microbial profile of bacteriobilia in patients undergoing pancreatic head resection (n = 285). Patients with preoperative biliary drainage (PBD+) had a significantly elevated risk of bacteriobilia. In those cases, the contamination was polymicrobiotic. Enterococcus was significantly more frequent in PBD+. Our standard preoperative antibiotic prophylaxis reaches an overall sensitivity rate of 60% and a resistance rate of 25% in 342 bacteria. The antibiotic efficiency of Imipenem and Piperacillin/Tazobactam is significantly higher in PBD+. The data on polymicrobial colonization of the biliary tract may be useful for the decision on antibiotic treatment in case of postoperative infection until the final results from the intraoperative smear are available. A more potent alternative for prophylactic application, however, was not found among the examined antibiotics.