Surgical Site Infections in Patients of Periampullary Carcinoma Undergoing Delayed Bile Duct Division (COMBILAST) in Whipple’s Procedure: A Prospective Cohort Study
Surgical site infections (SSIs) following a pancreaticoduodenectomy have been a significant cause of morbidity and even mortality. A modified sequence of the Whipple procedure, using the COMBILAST technique, may reduce SSIs and the patient’s hospital stay. This prospective cohort study included 42 p...
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MDPI AG
2023-03-01
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| Series: | Pathogens |
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| Online Access: | https://www.mdpi.com/2076-0817/12/3/448 |
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| author | Prakash Kumar Sasmal Kallol Kumar Das Poddar Tushar Subhadarshan Mishra Pankaj Kumar |
| author_facet | Prakash Kumar Sasmal Kallol Kumar Das Poddar Tushar Subhadarshan Mishra Pankaj Kumar |
| author_sort | Prakash Kumar Sasmal |
| collection | DOAJ |
| description | Surgical site infections (SSIs) following a pancreaticoduodenectomy have been a significant cause of morbidity and even mortality. A modified sequence of the Whipple procedure, using the COMBILAST technique, may reduce SSIs and the patient’s hospital stay. This prospective cohort study included 42 patients undergoing Whipple’s pancreaticoduodenectomy for a periampullary malignancy. The modified sequence pancreaticoduodenectomy technique, COMBILAST, was used to estimate the incidence of SSI and explore other advantages. Of the 42 patients, seven (16.7%) developed superficial SSIs, and two patients (4.8%) had an additional deep SSI. Positive intraoperative bile culture had the strongest association with SSI (OR: 20.25, 95% CI: 2.12, 193.91). The mean operative duration was 391.28 ± 67.86 min, and the mean blood loss was 705 ± 172 mL. A total of fourteen (33.3%) patients had a Clavien–Dindo grade of III or higher. Three (7.1%) patients died of septicemia. The average length of a hospital stay was 13.00 ± 5.92 days. A modified sequence of the Whipple procedure, using the COMBILAST technique, seems promising in reducing SSIs and the patient’s hospital stay. As the approach is only a modification of the operative sequence, it does not compromise the oncological safety of the patient. Moreover, it has an added surgical advantage in reducing the chance of injury to the aberrant or accessory right hepatic artery. |
| first_indexed | 2024-03-11T06:03:16Z |
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| language | English |
| last_indexed | 2024-03-11T06:03:16Z |
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| spelling | doaj.art-73243bd1752d4b988af9c783eaed24b72023-11-17T13:10:06ZengMDPI AGPathogens2076-08172023-03-0112344810.3390/pathogens12030448Surgical Site Infections in Patients of Periampullary Carcinoma Undergoing Delayed Bile Duct Division (COMBILAST) in Whipple’s Procedure: A Prospective Cohort StudyPrakash Kumar Sasmal0Kallol Kumar Das Poddar1Tushar Subhadarshan Mishra2Pankaj Kumar3Department of Surgery, AIIMS, Bhubaneswar 751019, Odisha, IndiaDepartment of Surgery, AIIMS, Bhubaneswar 751019, Odisha, IndiaDepartment of Surgery, AIIMS, Bhubaneswar 751019, Odisha, IndiaDepartment of Surgery, AIIMS, Bhubaneswar 751019, Odisha, IndiaSurgical site infections (SSIs) following a pancreaticoduodenectomy have been a significant cause of morbidity and even mortality. A modified sequence of the Whipple procedure, using the COMBILAST technique, may reduce SSIs and the patient’s hospital stay. This prospective cohort study included 42 patients undergoing Whipple’s pancreaticoduodenectomy for a periampullary malignancy. The modified sequence pancreaticoduodenectomy technique, COMBILAST, was used to estimate the incidence of SSI and explore other advantages. Of the 42 patients, seven (16.7%) developed superficial SSIs, and two patients (4.8%) had an additional deep SSI. Positive intraoperative bile culture had the strongest association with SSI (OR: 20.25, 95% CI: 2.12, 193.91). The mean operative duration was 391.28 ± 67.86 min, and the mean blood loss was 705 ± 172 mL. A total of fourteen (33.3%) patients had a Clavien–Dindo grade of III or higher. Three (7.1%) patients died of septicemia. The average length of a hospital stay was 13.00 ± 5.92 days. A modified sequence of the Whipple procedure, using the COMBILAST technique, seems promising in reducing SSIs and the patient’s hospital stay. As the approach is only a modification of the operative sequence, it does not compromise the oncological safety of the patient. Moreover, it has an added surgical advantage in reducing the chance of injury to the aberrant or accessory right hepatic artery.https://www.mdpi.com/2076-0817/12/3/448pancreaticoduodenectomyWhipple’s proceduresurgical site infectionsbiliary contaminationaberrant right hepatic arteryaccessory right hepatic artery |
| spellingShingle | Prakash Kumar Sasmal Kallol Kumar Das Poddar Tushar Subhadarshan Mishra Pankaj Kumar Surgical Site Infections in Patients of Periampullary Carcinoma Undergoing Delayed Bile Duct Division (COMBILAST) in Whipple’s Procedure: A Prospective Cohort Study Pathogens pancreaticoduodenectomy Whipple’s procedure surgical site infections biliary contamination aberrant right hepatic artery accessory right hepatic artery |
| title | Surgical Site Infections in Patients of Periampullary Carcinoma Undergoing Delayed Bile Duct Division (COMBILAST) in Whipple’s Procedure: A Prospective Cohort Study |
| title_full | Surgical Site Infections in Patients of Periampullary Carcinoma Undergoing Delayed Bile Duct Division (COMBILAST) in Whipple’s Procedure: A Prospective Cohort Study |
| title_fullStr | Surgical Site Infections in Patients of Periampullary Carcinoma Undergoing Delayed Bile Duct Division (COMBILAST) in Whipple’s Procedure: A Prospective Cohort Study |
| title_full_unstemmed | Surgical Site Infections in Patients of Periampullary Carcinoma Undergoing Delayed Bile Duct Division (COMBILAST) in Whipple’s Procedure: A Prospective Cohort Study |
| title_short | Surgical Site Infections in Patients of Periampullary Carcinoma Undergoing Delayed Bile Duct Division (COMBILAST) in Whipple’s Procedure: A Prospective Cohort Study |
| title_sort | surgical site infections in patients of periampullary carcinoma undergoing delayed bile duct division combilast in whipple s procedure a prospective cohort study |
| topic | pancreaticoduodenectomy Whipple’s procedure surgical site infections biliary contamination aberrant right hepatic artery accessory right hepatic artery |
| url | https://www.mdpi.com/2076-0817/12/3/448 |
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