Association between postoperative Clostridioides difficile infection and outcomes following pancreatoduodenectomy for pancreatic cancer: a national cohort study.

Fady Daniel, Batoul Abdallah, Ali R Chaitou, Maha Makki, Rudy Mrad, Mohamad Khalife, Hani Tamim

Abstract read

In one paragraph

Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed

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1 · What the graph read from it

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

FulminantAnnals of hepato-biliary-pancreatic surgery · 2026
Article

4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Fady DanielDivision of Gastroenterology and Hepatology, Department of Internal Medicine, American University of Beirut Medical Center, PO Box: 11-023, Riad El Solh, Beirut, 1107 2020, Lebanon. fd21@aub.edu.lb.

Batoul AbdallahDivision of Gastroenterology and Hepatology, Department of Internal Medicine, American University of Beirut Medical Center, PO Box: 11-023, Riad El Solh, Beirut, 1107 2020, Lebanon.

Ali R ChaitouDivision of Gastroenterology and Hepatology, Department of Internal Medicine, American University of Beirut Medical Center, PO Box: 11-023, Riad El Solh, Beirut, 1107 2020, Lebanon.

Maha MakkiDepartment of Internal Medicine, Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon.

Rudy MradDivision of Gastroenterology and Hepatology, Department of Internal Medicine, American University of Beirut Medical Center, PO Box: 11-023, Riad El Solh, Beirut, 1107 2020, Lebanon.

Mohamad KhalifeDivision of General Surgery, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon.

Hani TamimDepartment of Internal Medicine, Clinical Research Institute, American University of Beirut Medical Center, Beirut, Lebanon.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundClostridioides difficile infection (CDI) is a major healthcare-associated infection, but its impact after pancreatoduodenectomy (PD) for pancreatic cancer is unclear. This study assessed the incidence of CDI after PD for pancreatic cancer and evaluated preoperative factors associated with CDI, as well as the relationship between CDI and postoperative morbidity and mortality.

methodsA retrospective cohort study using the ACS-NSQIP database included patients who underwent PD for pancreatic head cancer. Patients were stratified by postoperative CDI, and univariate and multivariate logistic regression analyses identified risk factors and outcomes.

resultsAmong 16,757 patients, 249 (1.5%) developed postoperative CDI. Multivariate analysis showed increasing age (OR 1.21, p = 0.02), lower body weight (OR 0.95, p = 0.01), and recent chemotherapy (OR 1.47, p = 0.01) as independent predictors of postoperative CDI. Postoperative CDI was significantly associated with increased odds of composite morbidity (OR 1.62, p = 0.02), sepsis (OR 1.62, p = 0.02), pancreatic fistula (OR 2.01, p < 0.001), delayed gastric emptying (OR 1.79, p = 0.001), organ-space surgical site infection (OR 1.99, p < 0.001), wound disruption (OR 3.91, p < 0.001), and septic shock (OR 2.24, p = 0.007).

conclusionAlthough uncommon, CDI after PD was associated with increased morbidity in this cohort. Older patients, those with lower body weight, and patients receiving chemotherapy had higher odds of postoperative CDI and may benefit from close clinical monitoring and judicious antibiotic stewardship.

Indexed as

Clostridioides difficileClostridium InfectionsPancreatic NeoplasmsPancreaticoduodenectomyPostoperative ComplicationsAgedCohort StudiesFemaleHumansIncidenceMaleMiddle AgedRetrospective StudiesRisk FactorsUnited StatesACS-NSQIPClostridioides difficile infectionPancreatic cancerPancreatoduodenectomyPostoperative complicationsPostoperative morbidity

Identifiers

PMID42257924

DOI10.1007/s00464-026-12743-3

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