Evidence map›Paper›PMID 39402424›Full record

ArticleLangenbeck's archives of surgery2024

Impact of an enhanced anti-infection prophylaxis strategy for pancreatoduodenectomy: a single centre analysis.

Tina Groß, Felix Merboth, Anna Klimowa, Christoph Kahlert, Marius Distler, Jürgen Weitz, Thilo Welsch, Benjamin Müssle

Abstract read
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Article in Langenbeck's archives of surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Tina GroßDepartment of General, Visceral and Thoracic Surgery, University Hospital Hamburg-Ependorf, Hamburg, Germany.
Felix MerbothDepartment of Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Anna KlimowaNational Center for Tumor Diseases (NCT/UCC), Dresden, Germany.
Christoph KahlertDepartment of General, Visceral and Transplantation Surgery, University Hospital Heidberg, Heidelberg, Germany.
Marius DistlerDepartment of Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Jürgen WeitzDepartment of Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Thilo WelschDepartment of General, Visceral and Thoracic Surgery, University Hospital Hamburg-Ependorf, Hamburg, Germany.
Benjamin MüssleDepartment of Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany. benjamin-moritz.muessle@uniklinik-ulm.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionSurgical site infection (SSI) after pancreatoduodenectomy (PD) is a significant concern. Targeted antibiotic prophylaxis (pAP) has been tested to mitigate antibiotic resistance patterns, especially after preoperative bile duct stenting. The aim of this study was to investigate the effect of enhanced anti-infective prophylaxis (EAP) on the incidence of superficial and intraabdominal SSI.

methodsAll patients who underwent PD at a single centre between May 2018 and May 2021 were retrospectively analysed. A control cohort of patients who received pAP with intravenous cefuroxime and metronidazole and routine intraoperative abdominal lavage according to the surgeons' preferences. Since March 2020, pAP has been changed to piperacillin/tazobactam according to local resistance patterns and combined with routine intraoperative extended abdominal lavage (EIPL). Preoperative selective decontamination of the digestive tract (SDD) has been applied routinely since Jan 2019.

resultsIn total, 163 patients were included. The standard (n = 100) and EAP (n = 63) groups did not significantly differ with regard to pertinent patient and operative characteristics. In the EAP group, the rates of SSI (14% vs. 37%, p = 0.002, total rate: 28%) and urinary tract infection (24% vs. 8%, p = 0.011, total rate 18%) were significantly lower. Other septic complications were not significantly different. In addition, the risk of developing gastrointestinal bleeding and delayed gastric emptying was significantly lower in the EAP group. Multivariate analysis showed that an age > 67 years was a significant risk factor for SSI.

conclusionThe results indicate that enhanced anti-infective prophylaxis may significantly decrease the incidence of SSI in patients after PD.

Indexed as

Antibiotic ProphylaxisPancreaticoduodenectomySurgical Wound InfectionAgedAnti-Bacterial AgentsFemaleHumansIncidenceMaleMiddle AgedRetrospective StudiesAnti-Bacterial Agents

Identifiers

PMID39402424
PMCPMC11473572

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.