Causative effect of bacterial infection on pancreatic fistula and appropriate timing of drain removal after pancreaticoduodenectomy

Kimura, Norihisa; Ishido, Keinosuke; Kudo, Daisuke; Wakiya, Taiichi; Odagiri, Tadashi; Wakasa, Yusuke; Toyoki, Yoshikazu; Hakamada, Kenichi

doi:10.1016/j.pan.2016.05.367

Cited by 2 publications

(3 citation statements)

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“…are cefoxitin-resistant organisms found in bile, with the former identified significantly more in CR-POPF after PD [77], and as such, may also explain the observed superiority of piperacillin-tazobactam [109]. Moreover, as piperacillin-tazobactam was associated with a significant reduction in surgical site infections [102], curbing infective complications may, in turn, avoid the formation and exacerbation of CR-POPF for which it is a risk factor [110]. However, no effect was found in PD patients with positive preoperative bile cultures [111], undergoing preoperative biliary drainage [112], or high-risk patients receiving piperacillintazobactam and gentamicin prophylaxis for 2 to 5 days postoperatively [113].…”

Section: Antibioticsmentioning

confidence: 99%

Non-Surgical Interventions for the Prevention of Clinically Relevant Postoperative Pancreatic Fistula—A Narrative Review

Rykina-Tameeva,

Samra,

Sahni

et al. 2023

Cancers

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Clinically relevant postoperative pancreatic fistula (CR-POPF) is the leading cause of morbidity and mortality after pancreatic surgery. Post-pancreatectomy acute pancreatitis (PPAP) has been increasingly understood as a precursor and exacerbator of CR-POPF. No longer believed to be the consequence of surgical technique, the solution to preventing CR-POPF may lie instead in non-surgical, mainly pharmacological interventions. Five databases were searched, identifying eight pharmacological preventative strategies, including neoadjuvant therapy, somatostatin and its analogues, antibiotics, analgesia, corticosteroids, protease inhibitors, miscellaneous interventions with few reports, and combination strategies. Two further non-surgical interventions studied were nutrition and fluids. New potential interventions were also identified from related surgical and experimental contexts. Given the varied efficacy reported for these interventions, numerous opportunities for clarifying this heterogeneity remain. By reducing CR-POPF, patients may avoid morbid sequelae, experience shorter hospital stays, and ensure timely delivery of adjuvant therapy, overall aiding survival where prognosis, particularly in pancreatic cancer patients, is poor.

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Section: Antibioticsmentioning

confidence: 99%

Non-Surgical Interventions for the Prevention of Clinically Relevant Postoperative Pancreatic Fistula—A Narrative Review

Rykina-Tameeva,

Samra,

Sahni

et al. 2023

Cancers

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“…Kimura et al [ 146 ] identified contaminated drain fluid on POD1 and POD3 to be an independent risk factor for CR-POPF which has since been corroborated in the early postoperative period PODs 1-3[ 139 ], POD1[ 147 , 148 ] and POD3[ 142 , 149 ]. The accuracy of POD1 drain culture was reported by Hata et al [ 145 ] as having a sensitivity of 0.45 and specificity of 0.813 resulting in a positive predictive value (PPV) of 0.479, with specificity (0.99) similarly prevailing over sensitivity (0.32) in Morimoto et al ’s analysis of POD3 drain fluid smear tests which reported a superior PPV of 0.89[ 142 ].…”

Section: Introductionmentioning

confidence: 99%

“…Here, Enterococcus and Staphylococcus were also detected, conflicting later findings by Belmouhand’s group who reported no significant difference in the severity of POPF when drain fluid was similarly contaminated[ 150 ]. The commonly identified Enterococcus and Enterobacter species have been detected on POD1[ 146 ] and proposed to originate from bile[ 140 ]. Abe et al [ 162 ] detected Enterococcus and Enterobacter species in drain fluid with Yamashita et al [ 138 ] specifically identifying Enterococcus faecalis and Enterobacter cloacae as precipitating CR-POPF.…”

Section: Introductionmentioning

confidence: 99%

Drain fluid biomarkers for prediction and diagnosis of clinically relevant postoperative pancreatic fistula: A narrative review

Rykina-Tameeva¹,

Samra²,

Sahni³

et al. 2022

World J Gastrointest Surg

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Clinically relevant postoperative pancreatic fistula (CR-POPF) has continued to compromise patient recovery post-pancreatectomy despite decades of research seeking to improve risk prediction and diagnosis. The current diagnostic criteria for CR-POPF requires elevated drain fluid amylase to present alongside POPF-related complications including infection, haemorrhage and organ failure. These worrying sequelae necessitate earlier and easily obtainable biomarkers capable of reflecting evolving CR-POPF. Drain fluid has recently emerged as a promising source of biomarkers as it is derived from the pancreas and hence, capable of reflecting its postoperative condition. The present review aims to summarise the current knowledge of CR-POPF drain fluid biomarkers and identify gaps in the field to invigorate future research in this critical area of clinical need. These findings may provide robust diagnostic alternatives for CR-POPF and hence, to clarify their clinical utility require further reports detailing their diagnostic and/or predictive accuracy.

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Causative effect of bacterial infection on pancreatic fistula and appropriate timing of drain removal after pancreaticoduodenectomy

Cited by 2 publications

References 0 publications

Non-Surgical Interventions for the Prevention of Clinically Relevant Postoperative Pancreatic Fistula—A Narrative Review

Non-Surgical Interventions for the Prevention of Clinically Relevant Postoperative Pancreatic Fistula—A Narrative Review

Drain fluid biomarkers for prediction and diagnosis of clinically relevant postoperative pancreatic fistula: A narrative review

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