Observational studyLangenbeck's archives of surgery2026
Association between clinically relevant antibiotic-resistant biliary colonization and liver-specific complications following perihilar cholangiocarcinoma resection.
Observational study in Langenbeck's archives of surgery, 2026. 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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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
12 authors.
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Abstract
backgroundInternational guidelines recommend first-generation cephalosporins for preoperative antibiotic prophylaxis in patients undergoing resection for perihilar cholangiocarcinoma (pCCA). Knowledge on the resistance profile of biliary bacteria and its impact on liver-specific complications is limited. This study aimed to evaluate the biliary microbial spectrum, particularly focusing on the impact of resistant bacteria on liver-specific complications following pCCA resection.
methodsThis is a retrospective, single-center, observational study. All patients with resected pCCA at the University Hospital Frankfurt from July 2005 to December 2022 were included. The microbial spectrum was analyzed using intraoperative bile swabs.
resultsFrom 118 patients, 104 had an intraoperative bile swab taken. Microorganisms (bacteria, fungi) were detected in 89.4% of cases. 24% of the samples contained clinically relevant antibiotic-resistant bacteria, which were related with more severe postoperative bile leaks requiring relaparotomy (24% versus 8.8%, p = 0.055) and posthepatectomy liver failure (48% versus 25.3%, p = 0.031). 76.9% of the microbial isolates were resistant to in-house standard antibiotic prophylaxis with cefuroxime.
conclusionBiliary colonization with clinically relevant antibiotic-resistant bacteria is associated with liver-specific complications.
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