Does Fungal Biliary Contamination after Preoperative Biliary Drainage Increase Postoperative Complications after Pancreaticoduodenectomy?
(1) Background: preoperative biliary drainage before pancreaticoduodenectomy (PD) is associated with bacterial biliary contamination (>85%) and a significant increase in global and infectious complications. In view of the lack of published data, the aim of our study was to investigate the impact...
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MDPI AG
2020-09-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/12/10/2814 |
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| author | Pauline Tortajada Alain Sauvanet Stephanie Truant Nicolas Regenet Régis Souche Stéphane Benoist Fabrice Muscari Jean Marc Regimbeau Sebastien Gaujoux Antonio Sa Cunha Lillian Schwarz FRENCH-ACHBT Working Group |
| author_facet | Pauline Tortajada Alain Sauvanet Stephanie Truant Nicolas Regenet Régis Souche Stéphane Benoist Fabrice Muscari Jean Marc Regimbeau Sebastien Gaujoux Antonio Sa Cunha Lillian Schwarz FRENCH-ACHBT Working Group |
| author_sort | Pauline Tortajada |
| collection | DOAJ |
| description | (1) Background: preoperative biliary drainage before pancreaticoduodenectomy (PD) is associated with bacterial biliary contamination (>85%) and a significant increase in global and infectious complications. In view of the lack of published data, the aim of our study was to investigate the impact of fungal biliary contamination after biliary drainage on the complication rate after PD. (2) Methods: a multicentric retrospective study that included 224 patients who underwent PD after biliary drainage with intraoperative biliary culture. (3) Results: the global rate of positive intraoperative biliary sample was 92%. Respectively, the global rate of biliary bacterial contamination and the rate of fungal contamination were 75% and 25%, making it possible to identify two subgroups: bacterial contamination only (B+, <i>n</i> = 154), and bacterial and fungal contamination (BF+, <i>n</i> = 52). An extended duration of preoperative drainage (62 vs. 49 days; <i>p</i> = 0.08) increased the risk of fungal contamination. The overall and infectious complication rates were not different between the two groups. In the event of postoperative infectious or surgical complications, the infectious samples taken did not reveal more fungal infections in the BF+ group. (4) Conclusions: fungal biliary contamination, although frequent, does not seem to increase the rate of global and infectious complications after PD, preceded by preoperative biliary drainage. |
| first_indexed | 2024-03-10T15:56:40Z |
| format | Article |
| id | doaj.art-3cbffa05884846dca23ff27a64f54c74 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T15:56:40Z |
| publishDate | 2020-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-3cbffa05884846dca23ff27a64f54c742023-11-20T15:36:26ZengMDPI AGCancers2072-66942020-09-011210281410.3390/cancers12102814Does Fungal Biliary Contamination after Preoperative Biliary Drainage Increase Postoperative Complications after Pancreaticoduodenectomy?Pauline Tortajada0Alain Sauvanet1Stephanie Truant2Nicolas Regenet3Régis Souche4Stéphane Benoist5Fabrice Muscari6Jean Marc Regimbeau7Sebastien Gaujoux8Antonio Sa Cunha9Lillian Schwarz10FRENCH-ACHBT Working GroupDepartment of Digestive Surgery, Rouen University Hospital, 1 rue de Germont, F-76031 Rouen, CEDEX, FranceDepartment of Hepatobiliary and Liver Transplantation, Hôpital Beaujon, 100 Boulevard Général Leclerc, 92118 Clichy, FranceDepartment of Digestive Surgery and Transplantation, Hôpital Huriez, Rue Michel Polonowski, 59037 Lille, FranceDepartment of Digestive Surgery, CHU Nantes, 1 Place Alexis Ricordeau, 44000 Nantes, FranceDepartment of Hepatobiliary and Transplantation, CHU Montpelliers, 191 Avenue du Doyen Gaston Giraud, 34295 Montpellier, CEDEX 5, FranceDepartment of Digestive Surgery, CHU du Kremlin Bicêtre, 78 Rue du Général Leclerc, 94270 Le Kremlin-Bicêtre, FranceDepartment of Digestive Surgery and Transplantation, CHU Toulouse Rangueil, 1, Avenue du Pr Jean Poulhès, 31059 Toulouse, CEDEX, FranceDepartment of Digestive Surgery, CHU Amiens-Picardie Site Sud, 1 Rond-Point du Professeur Christian Cabrol, 80054 Amiens, CEDEX 1, FranceDepartment of Digestive Surgery, Hepatobiliary and Metabolic Surgery, Hôpital Cochin, 27 rue du Faubourg Saint-Jacques, 75014 Paris, FranceDepartment of Hepatobiliary and Liver Transplantation, Centre Hépato-Biliaire de Paul Brousse, 38 rue de la Chapelle, 94800 Villejuif, FranceDepartment of Digestive Surgery, Rouen University Hospital, 1 rue de Germont, F-76031 Rouen, CEDEX, France(1) Background: preoperative biliary drainage before pancreaticoduodenectomy (PD) is associated with bacterial biliary contamination (>85%) and a significant increase in global and infectious complications. In view of the lack of published data, the aim of our study was to investigate the impact of fungal biliary contamination after biliary drainage on the complication rate after PD. (2) Methods: a multicentric retrospective study that included 224 patients who underwent PD after biliary drainage with intraoperative biliary culture. (3) Results: the global rate of positive intraoperative biliary sample was 92%. Respectively, the global rate of biliary bacterial contamination and the rate of fungal contamination were 75% and 25%, making it possible to identify two subgroups: bacterial contamination only (B+, <i>n</i> = 154), and bacterial and fungal contamination (BF+, <i>n</i> = 52). An extended duration of preoperative drainage (62 vs. 49 days; <i>p</i> = 0.08) increased the risk of fungal contamination. The overall and infectious complication rates were not different between the two groups. In the event of postoperative infectious or surgical complications, the infectious samples taken did not reveal more fungal infections in the BF+ group. (4) Conclusions: fungal biliary contamination, although frequent, does not seem to increase the rate of global and infectious complications after PD, preceded by preoperative biliary drainage.https://www.mdpi.com/2072-6694/12/10/2814pancreaticoduodenectomybiliary drainagebiliary contaminationfungal infectioninfectious complications |
| spellingShingle | Pauline Tortajada Alain Sauvanet Stephanie Truant Nicolas Regenet Régis Souche Stéphane Benoist Fabrice Muscari Jean Marc Regimbeau Sebastien Gaujoux Antonio Sa Cunha Lillian Schwarz FRENCH-ACHBT Working Group Does Fungal Biliary Contamination after Preoperative Biliary Drainage Increase Postoperative Complications after Pancreaticoduodenectomy? Cancers pancreaticoduodenectomy biliary drainage biliary contamination fungal infection infectious complications |
| title | Does Fungal Biliary Contamination after Preoperative Biliary Drainage Increase Postoperative Complications after Pancreaticoduodenectomy? |
| title_full | Does Fungal Biliary Contamination after Preoperative Biliary Drainage Increase Postoperative Complications after Pancreaticoduodenectomy? |
| title_fullStr | Does Fungal Biliary Contamination after Preoperative Biliary Drainage Increase Postoperative Complications after Pancreaticoduodenectomy? |
| title_full_unstemmed | Does Fungal Biliary Contamination after Preoperative Biliary Drainage Increase Postoperative Complications after Pancreaticoduodenectomy? |
| title_short | Does Fungal Biliary Contamination after Preoperative Biliary Drainage Increase Postoperative Complications after Pancreaticoduodenectomy? |
| title_sort | does fungal biliary contamination after preoperative biliary drainage increase postoperative complications after pancreaticoduodenectomy |
| topic | pancreaticoduodenectomy biliary drainage biliary contamination fungal infection infectious complications |
| url | https://www.mdpi.com/2072-6694/12/10/2814 |
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