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Preoperative biliary drainage predisposes the bile to be contaminated with bacteria of the duodenum. These bacteria colonizing the bile are a potential source for surgical site infections after pancreaticoduodenectomy and many international guidelines recommend the use of cephalosporines as microbial prophylaxis before surgery. The aim of this study was to assess the incidence of bacteria in bile, their resistance profiles and association to surgical site infections in relation to timing of surgery after preoperative biliary drainage in order to better guide antibiotic use.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| No PBD | Patients without preoperative biliary drainage before pancreaticoduodenectomy | ||
| PBD < 2 months | Patients who had undergone preoperative biliary drainage and the pancreaticoduodenectomy was in 2 months after the drainage. |
| |
| PBD ≥ 2 months | Patients who had undergone preoperative biliary drainage and the pancreaticoduodenectomy was at 2 months or later after the drainage. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Preoperative biliary drainage | Procedure | Preoperative biliary drainage before pancreaticoduodenectomy. Might be needed if the biliary tract in obstructed and the surgery cannot be scheduled in near future. |
| Measure | Description | Time Frame |
|---|---|---|
| Rate of surgical site infections | 30 days post operatively | |
| Prevalence of cephalosporin resistance in intraoperative biliary cultures | At the time of operation |
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Inclusion Criteria:
Exclusion Criteria:
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All patients undergoing pancreaticoduodenectomy in a single high volume center between May 23rd 2016 to October 29th 2020.
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| Name | Affiliation | Role |
|---|---|---|
| Timo O Tarvainen, MD | Gastroenterological Surgery, Helsinki University Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Helsinki Central Hospital | Helsinki | Finland |
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| ID | Term |
|---|---|
| D013530 | Surgical Wound Infection |
| ID | Term |
|---|---|
| D014946 | Wound Infection |
| D007239 | Infections |
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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