title: The Effects of Total Colectomy on Bacterial Translocation in a Model of Acute Pancreatitis.
abstract: Prevention of secondary infection is currently the main goal of treatment for acute necrotizing pancreatitis. Colon was considered as the main origin of secondary infection. Our aim was to investigate whether prophylactic total colectomy would reduce the rate of bacterial translocation and infection of pancreatic necrosis. Forty-two Sprague-Dawley rats were used. Pancreatitis was created by ductal infusion of sodium taurocholate. Rats were divided into four groups: group-1, laparotomy + pancreatic ductal infusion of saline; group-2, laparotomy + pancreatic ductal infusion of sodium taurocholate; group-3, total colectomy + pancreatic ductal infusion of saline; and group-4, total colectomy + pancreatic ductal infusion of sodium taurocholate. Forty-eight hours later, tissue and blood samples were collected for microbiological and histopathological analysis. Total colectomy caused small bowel bacterial overgrowth with gram-negative and gram-positive microorganisms. Bacterial count of gram-negative rods in the small intestine and pancreatic tissue in rats with colectomy and acute pancreatitis were significantly higher than in rats with acute pancreatitis only (group-2 versus group-4; small bowel, p = <0.001; pancreas, p = 0.002). Significant correlation was found between proximal small bowel bacterial overgrowth and pancreatic infection (r = 0,836, p = 0.001). In acute pancreatitis, prophylactic total colectomy (which can mimic colonic cleansing and reduction of colonic flora) induces small bowel bacterial overgrowth, which is associated with increased bacterial translocation to the pancreas.
authors.affiliation: Department of General Surgery, Gülhane Military Medical Academy, 06018 Ankara, Turkey.
authors.forename: Rahman
authors.initials: R
authors.lastname: Şenocak
authors.affiliation: Department of General Surgery, Gülhane Military Medical Academy, 06018 Ankara, Turkey.
authors.forename: Taner
authors.initials: T
authors.lastname: Yigit
authors.affiliation: Department of General Surgery, Gülhane Military Medical Academy, 06018 Ankara, Turkey.
authors.forename: Zafer
authors.initials: Z
authors.lastname: Kılbaş
authors.affiliation: Department of General Surgery, Gülhane Military Medical Academy, 06018 Ankara, Turkey.
authors.forename: Ali Kağan
authors.initials: AK
authors.lastname: Coşkun
authors.affiliation: Department of General Surgery, Gülhane Military Medical Academy, 06018 Ankara, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Harlak
authors.affiliation: Department of General Surgery, Gülhane Military Medical Academy, 06018 Ankara, Turkey.
authors.forename: Mustafa Öner
authors.initials: MÖ
authors.lastname: Menteş
authors.affiliation: Department of Microbiology, Gülhane Military Medical Academy, Etlik Ankara, Turkey.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Kılıç
authors.affiliation: Department of Pathology, Gülhane Military Medical Academy, Etlik Ankara, Turkey.
authors.forename: Armağan
authors.initials: A
authors.lastname: Günal
authors.affiliation: Department of General Surgery, Gülhane Military Medical Academy, 06018 Ankara, Turkey.
authors.forename: Orhan
authors.initials: O
authors.lastname: Kozak
keywords: Acute pancreatitis; Bacterial translocation; Colonic cleansing; Intestinal flora