Risk factors for infectious complications after pancreaticoduodenectomy

Infectious postoperative complications after pancreaticoduodenectomy (PD) is still a major concern. In our study on a group of 43 patients operated on in 2023-24 it was shown that the main predictor of the development of early infectious complications was bile after preoperative drainage procedure. In the group of patients previously drained (group 1) due to mechanical jaundice (n=27), the number of complications was higher and amounted to 44.4% compared to 12.5% in the group of undrained (group 2) patients (n=16). From intraoperative bile culture in patients of the 1st group, opportunistic flora was isolated in 22 patients (81.5%) out of 27, in the 2nd group in 4 (25%) out of 16 patients. Constant pathogenic strains, in case of development of all types of infectious complications, were: K.pneumonia, P.aeruginosa, resistant strains of E. coli, E.faecium, K.oxitoca. Results of fecal microbiome testing correlated with results of bile culture in 72.7% of cases. Early prescription of targeted antibacterial therapy (based on microbiome testing results) can reduce the frequency of development of postoperative infectious complications.