title: Influence of bactibilia after preoperative biliary stenting on postoperative infectious complications.
abstract: The aim of this study was to correlate the bactibilia found after preoperative biliary stenting with that of the bacteriology of postoperative infectious complications in patients with obstructive jaundice. One hundred thirty-eight patients (83% malignant and 17% benign etiologies) with obstructive jaundice had both their bile and all postoperative infectious complications cultured. Eighty-six (62%) had preoperative biliary stents (stent group) and 52 (38%) did not (no-stent group). There were no differences for age, sex, incidence of malignancy, type of operation, estimated blood loss, transfusion requirements, hospital length of stay, morbidity, or mortality rates between the two groups. Of 31 infectious complications, 23 were in the stent group and eight were in the no-stent group (P > 0.05), but only 13 (42%) infectious complications had bacteria that were also cultured from the bile. Only wound infection (P = 0.03) and bacteremia (P = 0.04) were more likely to occur in stented patients. Taken together, these data show that preoperative biliary stenting increases the incidence of bactibilia, bacteremia, and wound infection rates but does not increase morbidity, mortality, or hospital length of stay. Jaundiced patients can undergo preoperative biliary stenting while maintaining an acceptable postoperative morbidity rate.
authors.affiliation: Department of Surgery, Indiana University School of Medicine, Indianapolis, USA. tjhoward@iupui.edu
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Howard
authors.forename: Jian
authors.initials: J
authors.lastname: Yu
authors.forename: Ryan B
authors.initials: RB
authors.lastname: Greene
authors.forename: Virgilio
authors.initials: V
authors.lastname: George
authors.forename: George M
authors.initials: GM
authors.lastname: Wairiuko
authors.forename: Seth A
authors.initials: SA
authors.lastname: Moore
authors.forename: James A
authors.initials: JA
authors.lastname: Madura
mesh_terms: D000713:Anastomosis, Roux-en-Y; D016470:Bacteremia / Q000382:microbiology; D001419:Bacteria / Q000145:classification / Q000302:isolation & purification; D001646:Bile / Q000382:microbiology*; D001661:Biliary Tract Neoplasms / Q000601:surgery; D016063:Blood Loss, Surgical; D001803:Blood Transfusion; D002768:Choledochostomy; D005260:Female; D006801:Humans; D041781:Jaundice, Obstructive / Q000601:surgery / Q000628:therapy*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000601:surgery; D016577:Pancreaticoduodenectomy; D010195:Pancreatitis / Q000601:surgery; D011183:Postoperative Complications; D011446:Prospective Studies; D015607:Stents / Q000009:adverse effects / Q000382:microbiology; D013530:Surgical Wound Infection / Q000209:etiology*; D015996:Survival Rate