Effect of Perioperative Synbiotic Treatment on Bacterial Translocation and Postoperative Infectious Complications after Pancreatoduodenectomy

Dig Surg. 2016;33(3):220-9. doi: 10.1159/000444459. Epub 2016 Mar 19.


Background/aims: This study investigated the effect of perioperative synbiotics on bacterial translocation to mesenteric lymph nodes (MLNs) and occurrence of infectious complications following pancreatoduodenectomy (PD; University Hospital Medical Information Network ID 000003705).

Methods: Patients who were scheduled to undergo PD were randomized to receive preoperative synbiotics or no synbiotics (control group). MLNs were harvested at laparotomy (MLN-1) and after the resection (MLN-2). Blood samples were collected before laparotomy (Blood-1) and on postoperative day 1 (Blood-2). Microorganisms in each sample were detected using a bacterium-specific ribosomal RNA-targeted reverse transcriptase-quantitative polymerase chain reaction.

Results: Forty-four patients were included. In all samples, the bacterial detection rate in the MLN-1, MLN-2, Blood-1, and Blood-2 was lower in the synbiotics group than in the control group, although it did not reach a statistically significant difference. There was a significant correlation between the positivity of bacteria in the MLN-2 and Blood-2 samples (p = 0.009). The incidence rate of overall infectious complications was not significantly different between the 2 groups. Among various perioperative factors, the incidence of pancreatic fistula was the only factor that had a significant association with the incidence of infectious complications.

Conclusion: The preoperative use of synbiotics did not affect the incidence of infectious complications following PD.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bacteremia / blood
  • Bacteremia / etiology
  • Bacteremia / prevention & control*
  • Bacterial Translocation*
  • Female
  • Humans
  • Lymph Node Excision*
  • Lymph Nodes / microbiology*
  • Lymph Nodes / surgery
  • Male
  • Mesentery
  • Middle Aged
  • Pancreatic Fistula / etiology*
  • Pancreaticoduodenectomy / adverse effects*
  • Pancreaticoduodenectomy / methods
  • Perioperative Care
  • Postoperative Complications / blood
  • Postoperative Complications / etiology
  • Postoperative Complications / prevention & control*
  • Synbiotics*