Clinical Implications of Intraoperative Bile Culture during Pancreatoduodenectomy in Terms of Short-Term Outcomes: Analysis of a Prospective Database in a Single Institute

Introduction: Bacteriobilia, the colonization of bacteria in bile, can be caused by obstructive cholangitis or preoperative biliary drainage (PBD), and is not uncommon condition patients undergoing pancreaticoduodenectomy (PD). This study aims to investigate effect intraoperatively detected bacteriobilia on surgical outcomes after PD. Methods: For who underwent PD Samsung Medical Center between 2018 2020, an intraoperative bile culture was performed prospectively their clinicopathological data were retrospectively reviewed. Surgical compared patients, classified according PBD bacteriobilia. Logistic regression analysis identify factors increasing postoperative complications. Results: A total 382 included 202 (52.9%) had (PBD group). Bacteriobilia significantly more common group comparing non-PBD (31.1% vs 75.2%, p < 0.001) but there no difference Among group, with major complications including CR-POPF endoscopic percutaneous (37.9% 14.6%, = 0.002; 17.0% 4.2%, 0.025, respectively). In multivariable analysis, increased risk wound (p 0.041), risks other short-term adverse outcomes. Conclusion: itself does exacerbate except for complication. Therefore, timing surgery could flexible bacteriobilia, without need wait negative cultures.