Dual‐center randomized clinical trial exploring the optimal duration of antimicrobial prophylaxis in patients undergoing pancreaticoduodenectomy following biliary drainage

摘要

Objectives The aim of this dual‐center randomized controlled trial was to determine the optimal duration of antimicrobial prophylaxis in patients treated with pancreaticoduodenectomy (PD) who underwent preoperative biliary drainage (PBD) but were without cholangitis. Background Some reports showed that PBD in patients undergoing pancreatectomy increased the rate of perioperative complications. However, no clinical trial has evaluated the optimal duration of antimicrobial prophylaxis with a focus on patients who underwent PD following PBD. Methods A total of 82 patients who underwent PD between March 2012 and December 2016 were randomly assigned to either a 1‐day group (n?=?40), in which cefozopran (CZOP) as antimicrobial prophylaxis was given only on the day of surgery, or a 5‐day group (n?=?42), in which CZOP was given for 5 consecutive days beginning on the day of surgery. We evaluated the incidence of infectious and other complications after PD. Results Outcomes were significantly better in the 1‐day group compared with the 5‐day group ( P Conclusion Single‐day prophylactic use of CZOP is appropriate for patients who undergo PD following PBD without preoperative cholangitis.