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Роль бактериохолии в развитии инфекционных осложнений панкреатодуоденальной резекции

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Частота инфекционных осложнений после панкреатодуоденальной резекции остается значительной. Бактериохолия у этой категории больных с высокой частотой развивается в результате предоперационного билиарного дренирования. Ее роль в развитии инфекции области хирургического вмешательства и методы воздействия на нее изучены недостаточно. Представлен анализ отечественной и зарубежной литературы, рассмотрена роль бактериохолии в развитии инфекции области хирургического вмешательства после панкреатодуоденальной резекции. Бактериохолия представляется одним из наиболее значимых факторов инфекции области хирургического вмешательства после этой операции. Бактериальная культура в интраоперационно полученном образце желчи и микробиом области хирургического вмешательства представлены патогенами, резистентными к стандартным препаратам, применяемым для периоперационной антибиотикопрофилактики. Для уменьшения частоты инфекционных осложнений в области хирургического вмешательства после панкреатодуоденальной резекции необходим дальнейший поиск методов воздействия на бактериохолию, в том числе пересмотр подходов к периоперационному назначению антибактериальных средств.

Ключевые слова:
желчные протоки, желчный пузырь, механическая желтуха, бактериохолия, панкреатодуоденальная резекция, инфекционные осложнения, антибиотикопрофилактика, bile ducts, gallbladder, obstructive jaundice, bacteriocholia, pancreaticoduodenal resection, infectious complications, antibiotic prophylaxis

Литература:
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Role of bacteriocholia in development of infectious complications of pancreaticoduodenal resection

The incidence of infectious complications after pancreaticoduodenal resection remains significant. High frequency of bacteriocholia in this category of patients is a result of preoperative biliary drainage. The role of bacteriocholia in the development of surgical site infection and the methods of exposure to it are yet to be studied. The authors presented the analysis of Russian and foreign literature and considered the role of bacteriocholia in the development of surgical site infection after pancreaticoduodenal resection. Bacteriocholia appears to be one of the most significant factors in the surgical site infection after this kind of resection. Bacterial cultures in the intraoperative bile sample and the surgical microbiome are represented by pathogens resistant to standard drugs used for perioperative antibiotic prophylaxis. In order to decrease the incidence of surgical site infections after the pancreaticoduodenal resection it is essential to continue searching for the methods of exposure to bacteriocholia including revision of the approaches to perioperative administration of antibacterial agents.

Keywords:
желчные протоки, желчный пузырь, механическая желтуха, бактериохолия, панкреатодуоденальная резекция, инфекционные осложнения, антибиотикопрофилактика, bile ducts, gallbladder, obstructive jaundice, bacteriocholia, pancreaticoduodenal resection, infectious complications, antibiotic prophylaxis