title: Current antibiotic prophylaxis in pancreatoduodenectomy in Japan.
abstract: OBJECTIVE
  The aim of this study was to investigate the current use of antibiotic prophylaxis (AP) in association with pancreatoduodenectomy (PD) in Japan, and to determine its surgical implications.
  
  
  METHODS
  We surveyed 2331 patients who underwent PD for treatment of disease in the periampullary region. Data, obtained during the period January 2002 through December 2003, from 111 major surgical services associated with the Japanese Society for Pancreatic Surgery, were analyzed with regard to patient characteristics, preoperative complications, AP, and postoperative morbidities.
  
  
  RESULTS
  Eighty-five (78.7%) of the 108 eligible institutions chose a first- or second-generation cephalosporin for AP, given for a mean duration of 4.3 days. At all but 1 institution, the first dose was administered prior to surgical incision of the skin. At 42% of the institutions, an additional antibiotic was administered during surgery. The overall rate of wound infection was 6.8% of the 2266 patients for whom data were available. Preoperative jaundice was found in 55.3% of these 2266 patients, and 92.6% of these jaundiced patients were suffering from preoperative infections. In addition, those with preoperative infections were also diagnosed as having biliary infections. The number of patients with preoperative jaundice in combination with preoperative infections was significantly related to the rate of postoperative morbidity (P < 0.0001).
  
  
  CONCLUSIONS
  Administration of AP in association with PD in Japan seems appropriate. Icteric patients with biliary infections are at high risk for postoperative morbidities and need careful monitoring after surgery.
authors.affiliation: Department of Surgery II, Yamaguchi University School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 755-8505, Japan.
authors.forename: Tomio
authors.initials: T
authors.lastname: Ueno
authors.forename: Koutaro
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Toru
authors.initials: T
authors.lastname: Kawaoka
authors.forename: Motonari
authors.initials: M
authors.lastname: Takashima
authors.forename: Masaaki
authors.initials: M
authors.lastname: Oka
mesh_terms: D019072:Antibiotic Prophylaxis / Q000379:methods*; D015897:Comorbidity; D006801:Humans; D007564:Japan; D007565:Jaundice / Q000150:complications; D016577:Pancreaticoduodenectomy; D013530:Surgical Wound Infection / Q000517:prevention & control