Relationship between bacterial infection and pancreatic leakage after pancreaticoduodenectomy

Abstract

Objective To analyze the relationship between postoperative infection and pancreatic leakage after pancreaticoduodenectomy, and to provide a reference and guidance for the application of antibiotics postoperative. Methods A total of 400 patients treated by pancreaticoduodenectomy from July 2014 to December 2018 in Henan Provincial People’s Hospital were enrolled. According to the severity of pancreatic leakage and pancreatic fistula, all patients were divided into non pancreatic fistula group (250 cases), biochemical leakage group (98 cases) and B/C pancreatic fistula group (52 cases). The postoperative infection, occurrence and severity of pancreatic leakage were counted. And the relationship between bacterial infection and pancreatic leakage was analyzed. Results Among the three groups, the bacterial infection rate was 4.00% (10/250) in the non pancreatic fistula group, 18.36% (18/98) in the biochemical leakage group, and 90.38% (47/52) in the B/C pancreatic fistula group, and the difference was statistically significant among the three groups (all P<0.05). In the B/C pancreatic fistula group, there were 40 patients with B-level pancreatic leakage, of which 36 patients had positive bacterial culture; and 12 patients in this group were with C-level pancreatic leakage, of which 11 patients were with positive bacterial culture. There was a significant difference in bacterial infection between B-level and C-level pancreatic fistula patients (P<0.05). Among the patients with positive result of bacterial culture within one week after operation, there were 15 cases with grade B pancreatic leakage and 9 cases with grade C pancreatic leakage; among the patients with positive result of bacterial culture one week after operation, 21 patients had grade B pancreatic leakage and 2 patients had grade C pancreatic leakage. There was no significant difference in the bacterial spectrum of patients with pancreatic leakage at different stages. Conclusions Bacterial infection is a risk factor for pancreatic leakage after pancreaticoduodenectomy, and the earlier the bacterial infection occurs, the worse the pancreatic leakage progress. Key words: Pancreaticoduodenectomy; Bacteria infection; Pancreatic leakage