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| Surgical site infection following pancreaticoduodenectomy in a referral cancer center in Mexico |
| Rodrigo Villasenor-Echavarri a , b , Javier Melchor-Ruan c , Mercedes Aranda-Audelo a , d , Gabriela Arredondo-Saldana c , Patricia Volkow-Fernandez a , Maria del Carmen Manzano-Robleda e , AlejandroE Padilla-Rosciano c , Diana Vilar-Compte a , ∗ |
a Department of Infectious Diseases, Instituto Nacional de Cancerología, Av. San Fernando 22, Belisario Domínguez Secc 16, Tlalpan, Mexico City, Mexico
b School of Medicine, Universidad Panamericana, Augusto Rodin No. 498, Insurgentes Mixcoac, Benito Juárez, Mexico City, Mexico
c Department of Digestive Tube and Hepatopancreatobiliary Tumors, Instituto Nacional de Cancerología, Av. San Fernando 22, Belisario Domínguez Secc 16, Tlalpan, Mexico City, Mexico
d Department of Infectious Diseases, Hospital Manuel Gea González, Calz. de Tlalpan 4800, Belisario Domínguez Secc 16, Tlalpan, Mexico City, Mexico
e Gastrointestinal and Endoscopy Department, Instituto Nacional de Cancerología, Av. San Fernando 22, Belisario Domínguez Secc 16, Tlalpan, Mexico City, Mexico
∗Corresponding author.
E-mail address: diana_vilar@yahoo.com.mx (D. Vilar-Compte). |
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Abstract Background: Pancreaticoduodenectomy is the standard treatment for resectable periampullary cancer. Surgical site infections (SSI) are common complications with increased morbidity. The study aimed to describe the prevalence, risk factors, microbiology, and outcomes of SSI among patients undergoing pancreaticoduodenectomy.
Methods: We conducted a retrospective study in a referral cancer center between January 2015 and June 2021. We analyzed baseline patient characteristics and SSI occurrence. Culture results and susceptibility patterns were described. Multivariate logistic regression was used to determine risk factors, proportional hazards model to evaluate mortality, and Kaplan-Meier analysis to assess long-term survival.
Results: A total of 219 patients were enrolled in the study; 101 (46%) developed SSI. Independent factors for SSI were diabetes mellitus, preoperative albumin level, biliary drainage, biliary prostheses, and clinically relevant postoperative pancreatic fistula. The main pathogens were Enterobacteria and Enterococci. Multidrug-resistance rate in SSI was high but not associated with increased mortality. Infected patients had higher odds of sepsis, longer hospital stay and intensive care unit stay, and readmission rate. Neither 30-day mortality nor long-term survival was significantly different between infected and non-infected patients.
Conclusions: SSI prevalence among patients undergoing pancreaticoduodenectomy was high and largely caused by resistant microorganisms. Most risk factors were related to preoperative instrumentation of the biliary tree. SSI was associated with greater risk of unfavorable outcomes; however, survival was unaffected.
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2024, Vol. 23 
