DOI: 10.36347/sjams.2023.v11i03.010

Pages: 537-543

Background: The standard of therapy for benign diseases, periampullary and ampullary cancers is pancreaticoduodenectomy (PD). These patient subgroups frequently present with obstructive jaundice, which is associated with increased morbidity due to impaired immunity and nutrition. It is controversial whether PBD should be applied routinely prior to pancreaticoduodenectomy. Objective: The purpose of this study is to investigate infectious complications of biliary decompression prior to pancreaticoduodenectomy in a patient with obstructive jaundice. Methods: This single-center, cross-sectional study was done at BSMMU from April 2021 to March 2022. The study comprised 48 pancreaticoduodenectomy patients who met the criteria. Two groups formed. Group I had preoperative biliary drainage (n=24) while Group II did not (n=24). After written consent, all patient data was collected in a standardized form. SPSS version 23.0 ran statistical analysis. Unpaired t-test was used to evaluate mean SD quantitative variables. Chi-square test was conducted to see any association between qualitative observations and frequencies and percentages. P 0.05 was considered statistically significant in 95% confidence interval tests. Results: Overall infectious complications were not significant between two group (75%vs 41.7%; p=0.097). But SSI was higher in stent group (p=0.040). This stent group also observed higher positive bile culture 83.3% with significant polymicrobial growth (p=0.012). Commonly used antibiotics showed higher resistance to those biliary organisms; Cephalosporin (50 75%), Carbapenem (41.7%). There was also significant association between positive bile culture with SSI (p=0.048). Per- operative adhesion (p=0.001) and blood loss (p= 0.006) observed more in stent group. Although significant improvement of liver function observed following stenting. Conclusions: Increased risk of resistant polymicrobial bactibilia with strong association with SSI; preoperative biliary .......