关键词: 抗菌药, 胰十二指肠切除术, 术后并发症, 腹腔镜胰十二指肠切除术, 开放式胰十二指肠切除术

Abstract: Objective This study aimed to evaluate the application value of prophylactic broad-spectrum antimicrobials use in reducing complications after pancreaticoduodenectomy. Methods A retrospective analysis was conducted on 83 patients who underwent pancreaticoduodenectomy at Guangdong Medical University Affiliated Hospital from October 2018 to October 2023. The patients were divided into an observative group （receiving prophylactic treatment with broad-spectrum antimicrobial agents, n=40） and a control group （not receiving prophylactic treatment with narrow-spectrum antimicrobial agents, n=43）. Characteristics in patients such as gender, age, body mass index, pancreatic texture, pancreatic duct diameter, preoperative jaundice, preoperative percutaneous transhepatic cholangiodrainage （PTCD）, and preoperative biliary stent implantation were collected and analyzed for both groups. The positive bile culture rate, infection indicators （PCT, white blood cell count, CRP, postoperative fever）, as well as the incidence of postoperative abdominal infection, abdominal bleeding, delayed gastric emptying （DGE）, CRPOPF, and incision infection were compared between the two groups. Differences in hospitalization duration and costs were also analyzed. Results Prior to surgery, there were no statistically significant differences in demographic characteristics and infection indicators between the two groups. On the first postoperative day, infection indicators （PCT, white blood cell count, CRP） for both groups were elevated compared to preoperative levels. However, the observative group showed lower levels compared to the control group, and these differences were statistically significant. In terms of postoperative fever, there were 3 cases in the experimental group and 12 cases in the control group, with a statistically significant difference. Furthermore, there were no statistically significant differences in demographic characteristics between the fever group and the normal body temperature group （P>0.05）. However, the positive bile culture rate in the fever group was higher than that in the normal body temperature group, and this difference was statistically significant （P<0.05）. Additionally, the observative group had a higher rate of positive bile culture than the control group. Regarding postoperative complications, there were statistically significant differences between the two groups in terms of incision infection, abdominal infection, delayed gastric emptying （DGE）, and abdominal bleeding, while there were no significant differences in the incidence of other postoperative complications. The observative group had a shorter hospital stay and lower hospitalization costs. Conclusion Prophylactic use of broad-spectrum antimicrobials has a certain effect in reducing complications after pancreaticoduodenectomy, including incision infection, abdominal infection, delayed gastric emptying （DGE）, and abdominal bleeding. It can also improve patient prognosis by shortening hospitalization duration and reducing hospitalization costs.

Key words: antibiotics, pancreaticoduodenectomy, postoperative complications, laparoscopic pancreaticoduodenectomy, open pancreaticoduodenectomy