Antibiotic Prophylaxis in Surgery for Periampullary Processes

Introduction: Infectious complications after pancreatic surgery, especially in periampullary pathology, are very frequent and involve high morbidity. It is therefore essential to administer adequate prophylaxis and to establish objective criteria for postoperative antibiotic treatment. Materials and Methods: This is a 2-year retrospective longitudinal study analyzing antibiotic prophylaxis in pancreatic surgery according to whether patients were carriers of preoperative biliary drainage (PBD) or not. Cefazolin was used in cases without PBD, as well as piperacillin/tazobactam, in carriers with PBD. Resistance and surgical complications, especially infectious complications, were studied. Results: The most frequently isolated microorganisms in the bile cultures were Enterococcus sp. and Klebsiella sp., with 7% β-lactamases of extended spectrum (BLEE). Significant resistance to the antibiotic therapy used, especially to piperacillin-tazobactam, has been described. Surgical site infections were described in 65% of patients with biliary drainage and in 27% of patients without drainage. Conclusions: Analysis of bacteriobilia found in periampullary surgeries shows a high number of resistance to established antibiotic prophylaxis, especially in cases with PBD. This could explain the infectious complications during the postoperative period.