The clinical significance of intraoperative lavage fluid culture during pancreaticoduodenectomy on organ/space surgical site infection

Abstract Organ/space surgical site infection (SSI) are common after pancreaticoduodenectomy (PD). There is limited research on the clinical impact of intraoperative lavage fluid contamination in patients undergoing PD. One hundred five patients who underwent PD between August 2022 and July 2023 were...

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Main Authors: Yifei Yang, Jianjie Sheng, Chenglin Lu, Hao Cheng, Gang Li, Liang Mao, Chuang Chen, Yudong Qiu, Chang Liu, Xu Fu
Format: Article
Language:English
Published: Nature Portfolio 2024-11-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-024-80245-0
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author Yifei Yang
Jianjie Sheng
Chenglin Lu
Hao Cheng
Gang Li
Liang Mao
Chuang Chen
Yudong Qiu
Chang Liu
Xu Fu
author_facet Yifei Yang
Jianjie Sheng
Chenglin Lu
Hao Cheng
Gang Li
Liang Mao
Chuang Chen
Yudong Qiu
Chang Liu
Xu Fu
author_sort Yifei Yang
collection DOAJ
description Abstract Organ/space surgical site infection (SSI) are common after pancreaticoduodenectomy (PD). There is limited research on the clinical impact of intraoperative lavage fluid contamination in patients undergoing PD. One hundred five patients who underwent PD between August 2022 and July 2023 were retrospectively enrolled. The intraoperative bile and peritoneal lavage were collected for bacterial culture. Postoperative drainage bacterial cultures were performed every 2–3 days thereafter until drains were all removed. The bacteria isolated from intraoperative lavage fluid, intraoperative bile, and postoperative drainage fluid were examined in detail. The risk factors associated with positive intraoperative lavage fluid culture were analyzed through both univariate and multivariate analyses. Organ/space SSI occurred in 59(56.2%) of the 105 patients. The positivity rates of cultures in intraoperative lavage fluid, intraoperative bile, and postoperative drainage fluid were found to be 41.0%, 67.6%, and 84.8%, respectively. Patients with positive intraoperative lavage fluid culture had a significantly higher occurrence of organ/space SSI compared to the negative group (69.0% vs. 29.4%, P < 0.001). Preoperative biliary drainage (PBD) was identified as the only independent risk factor for the contamination of intraoperative lavage fluid (OR = 7.687, 95% CI: 2.164–27.300, P = 0.002). K. pneumoniae was the most common isolates both in the intraoperative lavage fluid and postoperative drainage fluid. Intraoperative lavage fluid contamination closely correlated with organ/space SSI after PD. Meanwhile, PBD was the only risk factor for the contamination of intraoperative lavage fluid.
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spelling doaj-art-1ebe251c76fc4d24b01658ca456b58022025-08-20T02:22:20ZengNature PortfolioScientific Reports2045-23222024-11-011411810.1038/s41598-024-80245-0The clinical significance of intraoperative lavage fluid culture during pancreaticoduodenectomy on organ/space surgical site infectionYifei Yang0Jianjie Sheng1Chenglin Lu2Hao Cheng3Gang Li4Liang Mao5Chuang Chen6Yudong Qiu7Chang Liu8Xu Fu9Department of Pancreatic and Metabolic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing UniversityDepartment of Pancreatic and Metabolic Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese MedicineDepartment of Pancreatic and Metabolic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing UniversityDepartment of Pancreatic and Metabolic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing UniversityDepartment of Pancreatic and Metabolic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing UniversityDepartment of Pancreatic and Metabolic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing UniversityDepartment of Hepatopancreatobiliary Surgery, The Affiliated Huai’ an Hospital of Xuzhou Medical UniversityDepartment of Pancreatic and Metabolic Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese MedicineDepartment of Clinical Laboratory, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing UniversityDepartment of Pancreatic and Metabolic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing UniversityAbstract Organ/space surgical site infection (SSI) are common after pancreaticoduodenectomy (PD). There is limited research on the clinical impact of intraoperative lavage fluid contamination in patients undergoing PD. One hundred five patients who underwent PD between August 2022 and July 2023 were retrospectively enrolled. The intraoperative bile and peritoneal lavage were collected for bacterial culture. Postoperative drainage bacterial cultures were performed every 2–3 days thereafter until drains were all removed. The bacteria isolated from intraoperative lavage fluid, intraoperative bile, and postoperative drainage fluid were examined in detail. The risk factors associated with positive intraoperative lavage fluid culture were analyzed through both univariate and multivariate analyses. Organ/space SSI occurred in 59(56.2%) of the 105 patients. The positivity rates of cultures in intraoperative lavage fluid, intraoperative bile, and postoperative drainage fluid were found to be 41.0%, 67.6%, and 84.8%, respectively. Patients with positive intraoperative lavage fluid culture had a significantly higher occurrence of organ/space SSI compared to the negative group (69.0% vs. 29.4%, P < 0.001). Preoperative biliary drainage (PBD) was identified as the only independent risk factor for the contamination of intraoperative lavage fluid (OR = 7.687, 95% CI: 2.164–27.300, P = 0.002). K. pneumoniae was the most common isolates both in the intraoperative lavage fluid and postoperative drainage fluid. Intraoperative lavage fluid contamination closely correlated with organ/space SSI after PD. Meanwhile, PBD was the only risk factor for the contamination of intraoperative lavage fluid.https://doi.org/10.1038/s41598-024-80245-0PancreaticoduodenectomySurgical site infectionIntraoperative lavage
spellingShingle Yifei Yang
Jianjie Sheng
Chenglin Lu
Hao Cheng
Gang Li
Liang Mao
Chuang Chen
Yudong Qiu
Chang Liu
Xu Fu
The clinical significance of intraoperative lavage fluid culture during pancreaticoduodenectomy on organ/space surgical site infection
Scientific Reports
Pancreaticoduodenectomy
Surgical site infection
Intraoperative lavage
title The clinical significance of intraoperative lavage fluid culture during pancreaticoduodenectomy on organ/space surgical site infection
title_full The clinical significance of intraoperative lavage fluid culture during pancreaticoduodenectomy on organ/space surgical site infection
title_fullStr The clinical significance of intraoperative lavage fluid culture during pancreaticoduodenectomy on organ/space surgical site infection
title_full_unstemmed The clinical significance of intraoperative lavage fluid culture during pancreaticoduodenectomy on organ/space surgical site infection
title_short The clinical significance of intraoperative lavage fluid culture during pancreaticoduodenectomy on organ/space surgical site infection
title_sort clinical significance of intraoperative lavage fluid culture during pancreaticoduodenectomy on organ space surgical site infection
topic Pancreaticoduodenectomy
Surgical site infection
Intraoperative lavage
url https://doi.org/10.1038/s41598-024-80245-0
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