Preoperative mechanical bowel preparation does not offer a benefit for patients who undergo pancreaticoduodenectomy.
BACKGROUND
Mechanical bowel preparations (MBPs) are commonly administered preoperatively to patients who undergo pancreaticoduodenectomy (PD); however, their effectiveness over a clear liquid diet (CLD) preparation remains unclear. The aim of this study was to determine whether MBP offers an advantage to patients who undergo PD.


METHODS
In this retrospective review, we analyzed the clinical data from 100 consecutive PDs performed on patients who received preoperative MBP from March 2006 to April 2007, and we compared them with 100 consecutive patients who received a preoperative CLD from May 2007 to March 2008.


RESULTS
No differences were observed between the MBP and CLD groups in the rates of pancreatic fistula (13% vs 14%; P = 1.0), intra-abdominal abscess (11% vs 13%; P = .83), or wound infection (9% vs 8%; P = 1.0). Trends toward increased urinary tract infections (13% vs 5%; P < .08) and Clostridium difficile infections were found in the MBP group (6% vs 1%; P = .12). The median duration of postoperative hospital stay was 7 days in each group, and the 12-month survival rates were equivalent (74% vs 75%; P = 1.0).


CONCLUSIONS
There is no clinical benefit to the administration of a preoperative MBP for patients undergoing PD.
Lavu
Harish
H
Department of Surgery, Jefferson Pancreas, Biliary and Related Cancer Center, Thomas Jefferson University, Philadelphia, PA 19107, USA. harish.lavu@jefferson.edu
Kennedy
Eugene P
EP
Mazo
Ross
R
Stewart
Robert J
RJ
Greenleaf
Christopher
C
Grenda
Dane R
DR
Sauter
Patricia K
PK
Leiby
Benjamin E
BE
Croker
Sean P
SP
Yeo
Charles J
CJ
D018784:Abdominal Abscess / Q000517:prevention & control; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002400:Cathartics / Q000008:administration & dosage*; D016360:Clostridioides difficile; D004032:Diet; D004761:Enterocolitis, Pseudomembranous / Q000517:prevention & control; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010185:Pancreatic Fistula / Q000517:prevention & control; D016577:Pancreaticoduodenectomy / Q000009:adverse effects; D011183:Postoperative Complications / Q000517:prevention & control*; D011300:Preoperative Care / Q000379:methods*; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000517:prevention & control; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000517:prevention & control
D002400:Cathartics