Journal of Clinical Gastroenterology and Hepatology Open Access

PATTERN OF MICROBIOLOGY CULTURES BILIARY STENTS IN PATIENTS UNDERGOING PANCREATICODUODENECTOMY(PD)

Annual Summit on Hepatology and Pancreatic Diseases

November 12-13, 2018 Paris, France

Umer Farooq

Shaukat Khanum Memorial Cancer Hospital And Research Center, Pakistan

Posters & Accepted Abstracts: J Clin Gastroenterol Hepatol

Abstract:

Routine use of biliary drainage with stents before pancreaticoduodenectomy (PD) remains controversial. Stents have been shown to increase the rate of septic complications after surgery. This observational study assessed the patterns of bacterial cultures of stents retrieved during surgery , their sensitivities with commonly used antibiotics and also cultures of any wound or organ space infections. From the period of December 2014 to may 2018 a total of 161 patients were considered amenable for resection at Shaukat Khanum memorial cancer hospital and research center (SKMCH&RC) .Pre operative stenting was performed in 127 patients. 122 patients underwent PD whereas a de functioning bypass procedure was performed in 28 patients, while 11 patients were deemed unresectable. Out of these 122 patients who had PD, 98 patients were pre operatively stented. Stents were retrieved from 81 patients. Cultures of stents showed E.coli to be the most common bacteria (69.7%) followed by enterococcus (32.5%) and klebsiella (23.6%). 55.6% patients had poly microbial infection. Candida was isolated from a single patient while one patient had no growth of any microorganism on stent tip cultures. Antibiotics sensitivities showed that 57% cultures were sensitive to piperacillin/tazobactum group while 85.7% were sensitive to carbapenem group. Wound related complications were seen in around 45 % patients. Cultures from wounds showed concordance with the cultures obtained from stents in majority of the cases. Conclusion : Patients who were stented preoperatively have high incidence of poly microbial postoperative infections. Combination of drugs can be used prophylactically in early postoperative period to counter varied spectrum of antibiotic sensitivities and resistance. Stents should be sent for cultures in all patients undergoing PD after pre operative biliary stenting. Wound cultures should be obtained.

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