Scholarlink

Purpose <p>To investigate the risk factors for late postoperative pancreatic fistula (POPF) following pancreaticoduodenectomy (PD), with a focus on positive drain fluid culture (DFC) results on postoperative day (POD) 1.</p> Methods <p>Medical records of 198 patients who underwent PD with drain fluid amylase (DFA) on POD 5 &lt; 3x upper limit of normal (ULN) were included. Late POPF was defined as POPF diagnosed post-POD 6, with DFA on POD 5 &lt; 3xULN. Risk factors analyses were performed, with a focus on DFC on POD 1.</p> Results <p>Nineteen patients (9.6%) were diagnosed with late POPF. Age &gt; 65 years (OR: 4.019, <i>P</i> = 0.034) and positive DFC on POD 1 (OR: 10.151, <i>P</i> &lt; 0.001) were identified as independent predictors of late POPF. Patients with positive DFC on POD 1 (<i>n</i> = 25) had higher rates of late POPF (44% vs. 4.6%, <i>P</i> &lt; 0.001), postpancreatectomy hemorrhage (20% vs. 5.8%, <i>P</i> = 0.027) and Clavien–Dindo ≥ IIIa complications (44% vs. 6.4%, <i>P</i> &lt; 0.001). The majority of patients (57.9%) with late POPF had positive DFC on POD 1 (11 of 19, 57.9%). The isolates from 11 patients with positive DFC on POD 1 yielded 12 microorganisms, the most prevalent of which were Enterobacter (<i>n</i> = 7), followed by Enterococcus (<i>n</i> = 3) and Staphylococcus (<i>n</i> = 2). Cefmetazole resistance was detected in 66.7% (8 of 12) of the microorganisms.</p> Conclusion <p>Age &gt; 65 years and positive DFC on POD 1 were independent predictors of late POPF after PD. Positive DFC on POD 1 was associated with a higher rate of complications.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Positive drain fluid culture on postoperative day one is associated with an increased risk of late postoperative pancreatic fistula after pancreaticoduodenectomy

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年1月28日

查看全文
  • Bingjun Tang,
  • Yan Wen,
  • Sijia Li,
  • Jiming Ma,
  • Liuqing Yang,
  • Ning Duan,
  • Canhong Xiang,
  • Xiaodong Tian,
  • Jiahong Dong,
  • Pengfei Wang,
  • Xuedong Wang

摘要

Purpose

To investigate the risk factors for late postoperative pancreatic fistula (POPF) following pancreaticoduodenectomy (PD), with a focus on positive drain fluid culture (DFC) results on postoperative day (POD) 1.

Methods

Medical records of 198 patients who underwent PD with drain fluid amylase (DFA) on POD 5 < 3x upper limit of normal (ULN) were included. Late POPF was defined as POPF diagnosed post-POD 6, with DFA on POD 5 < 3xULN. Risk factors analyses were performed, with a focus on DFC on POD 1.

Results

Nineteen patients (9.6%) were diagnosed with late POPF. Age > 65 years (OR: 4.019, P = 0.034) and positive DFC on POD 1 (OR: 10.151, P < 0.001) were identified as independent predictors of late POPF. Patients with positive DFC on POD 1 (n = 25) had higher rates of late POPF (44% vs. 4.6%, P < 0.001), postpancreatectomy hemorrhage (20% vs. 5.8%, P = 0.027) and Clavien–Dindo ≥ IIIa complications (44% vs. 6.4%, P < 0.001). The majority of patients (57.9%) with late POPF had positive DFC on POD 1 (11 of 19, 57.9%). The isolates from 11 patients with positive DFC on POD 1 yielded 12 microorganisms, the most prevalent of which were Enterobacter (n = 7), followed by Enterococcus (n = 3) and Staphylococcus (n = 2). Cefmetazole resistance was detected in 66.7% (8 of 12) of the microorganisms.

Conclusion

Age > 65 years and positive DFC on POD 1 were independent predictors of late POPF after PD. Positive DFC on POD 1 was associated with a higher rate of complications.