Authors
Faruk Koca, Hanan El Youzouri, Svenja Sliwinski, Konstantin Uttinger, Ursula Pession, Ekaterina Petrova, Dirk Walter, Michael Hogardt, Volkhard A J Kempf, Andreas A Schnitzbauer, Armin Wiegering, Tamás Benkö
Published in
Langenbeck's archives of surgery. Volume 411. Issue 1. Jul 17, 2026. Epub Jul 17, 2026.
Abstract
International guidelines recommend first-generation cephalosporins for preoperative antibiotic prophylaxis in patients undergoing resection for perihilar cholangiocarcinoma (pCCA). Knowledge on the resistance profile of biliary bacteria and its impact on liver-specific complications is limited. This study aimed to evaluate the biliary microbial spectrum, particularly focusing on the impact of resistant bacteria on liver-specific complications following pCCA resection.
This is a retrospective, single-center, observational study. All patients with resected pCCA at the University Hospital Frankfurt from July 2005 to December 2022 were included. The microbial spectrum was analyzed using intraoperative bile swabs.
From 118 patients, 104 had an intraoperative bile swab taken. Microorganisms (bacteria, fungi) were detected in 89.4% of cases. 24% of the samples contained clinically relevant antibiotic-resistant bacteria, which were related with more severe postoperative bile leaks requiring relaparotomy (24% versus 8.8%, p = 0.055) and posthepatectomy liver failure (48% versus 25.3%, p = 0.031). 76.9% of the microbial isolates were resistant to in-house standard antibiotic prophylaxis with cefuroxime.
Biliary colonization with clinically relevant antibiotic-resistant bacteria is associated with liver-specific complications.
PMID:
42467107
Bibliographic data and abstract were imported from PubMed on 17 Jul 2026.
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