Prognostic Impact of Bacterobilia on Morbidity and Postoperative Management After Pancreatoduodenectomy: A Systematic Review and Meta-analysis

World Journal of Surgery
Benjamin MüssleThilo Welsch

Abstract

Intraoperative bile analysis during pancreatoduodenectomy (PD) is performed routinely at specialized centers worldwide. However, it remains controversial if and how intraoperative bacterobilia during PD affects morbidity and its management. The aim of the study was a systematic review and meta-analysis of intraoperative bacterobilia and its impact on patient outcome after PD. Five relevant outcomes of interest were defined, and a systematic review of the literature with meta-analysis was performed according to the PRISMA guidelines. A total of 28 studies (8523 patients) were included. The median incidence of bacterobilia was 58% (interquartile range 51-67%). The most frequently isolated bacteria were Enterococcus species (51%), Klebsiella species (28%), and Escherichia coli (27%). Preoperative biliary drainage was significantly associated with bacterobilia (86 vs. 25%; RR 3.27; 95% confidence interval (CI) 2.42-4.42; p < 0.001). The incidence of surgical site infections (SSI) was significantly increased in cases with bacterobilia (RR 2.84; 95% CI 2.17-3.73; p < 0.001). Postoperative pancreatic fistula, overall postoperative morbidity, and mortality were not significantly influenced. Identical bacteria in bile and the infectious...Continue Reading

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Citations

Jan 1, 2020·World Journal of Surgical Oncology·Keishi SugimachiYasushi Toh
Oct 12, 2020·American Journal of Surgery·Syed Omair NadeemJuan M Sarmiento
Dec 15, 2020·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Jesse V GroenJ Sven D Mieog
Jul 25, 2021·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Marina L ParapiniPeter T Kim

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