ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2016
Poor Results of Pancreatoduodenectomy in High-Risk Patients with Endoscopic Stent and Bile Colonization are Associated with E. coli, Diabetes and Advanced Age.
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07321470 (A Single Center Prospective Randomized Trial of Complete vs. Postoperative Nasogastric Tube Omission in Pancreaticoduodenectomied Patients), which is not on this map. Cited by 11 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Single Center Prospective Randomized Trial of Complete vs. Postoperative Nasogastric Tube Omission in Pancreaticoduodenectomied Patients
Who cites it
11 citing papers in PubMed, 25 citations in OpenAlex.
- Rapid, intense pericholedochal fibrosis after preoperative biliary drainage: A prospective histologic study in pancreatoduodenectomy specimens.Annals of hepato-biliary-pancreatic surgery · 2026Article
- Exploring the effects of gut microbiota on cholangiocarcinoma progression by patient-derived organoids.Journal of translational medicine · 2025Review
- Article
- Antibiotic Prophylaxis for Hepato-Biliopancreatic Surgery-A Systematic Review.Antibiotics (Basel, Switzerland) · 2022Review
- Specific Bile Microorganisms Caused by Intra-Abdominal Abscess on Pancreaticoduodenectomy Patients: A Retrospective Cohort Study.Current oncology (Toronto, Ont.) · 2021Article
- Implementation of a strategic preoperative surgical meeting to improve the level of care at a high-volume pancreatic center: a before-after analysis of 1000 consecutive cases.Updates in surgery · 2020Article
- Unmet needs in preoperative biliary stenting for patient candidates for pancreaticoduodenectomy: a viewpoint.Hepatobiliary surgery and nutrition · 2019Article
- The microbiota of the bilio-pancreatic system: a cohort, STROBE-compliant study.Infection and drug resistance · 2019Article
- Effectiveness and risk of biliary drainage prior to pancreatoduodenectomy: review of current status.Surgery today · 2018Review
- Consequences of Increases in Antibiotic Resistance Pattern on Outcome of Pancreatic Resection for Cancer.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2017Observational
- Pancreaticoduodenectomy in patients ≥ 75 years of age: Are there any differences with other age ranges in oncological and surgical outcomes? Results from a tertiary referral center.World journal of gastroenterology · 2017Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEndoscopic stenting has spread as bridge management before pancreatoduedenectomy (PD) to resolve jaundice, but its role is nowadays challenged as it is reported to increase morbidity. Although bile sampling is increasingly performed, its clinical role is unclear. The objective of the study is to assess bile colonization's impact on outcome.
methodsResults of pancreatoduodenectomy after endoscopic stenting are analyzed in 61 high-risk patients presenting bacterial bile colonization. The impact of 11 demographic, clinical, infectious, and laboratory parameters and outcome, including pancreatic leakage, morbidity, and mortality, is analyzed.
resultsAll stented patients present bacterial bile colonization and PD mortality approaches 10 %. The presence of E. coli in the bile is significantly related to poor outcome, including 23.5 % mortality (p = 0.034), whereas age (≥70 years) and diabetes present borderline results (p < 0.070 and p < 0.066, respectively). E. coli (p = 0.002) and age (p = 0.017) are also related to grade C pancreatic fistula.
conclusionsIn high-risk patients undergoing PD, bile colonization inevitably occurs after endoscopic stenting and is a major risk factor of poor outcome, reaching its maximum in the case of E. coli colonization and elderly patients, where the indication to stent and/or to perform PD should be accurately evaluated. E. coli-targeted antibiotic prophylaxis should be administered.
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