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

摘要： 目的 评价预防性使用广谱抗菌药在减少胰十二指肠切除术后并发症中的应用价值。方法 对2018年10月至2023年10月在广东医科大学附属医院接受胰十二指肠切除术的83名患者进行了回顾性分析。患者被分为观察组（接受预防性使用广谱抗菌药治疗,共40人）和对照组（接受预防性使用窄谱抗菌药治疗,共43人）。收集和分析两组患者的性别、年龄、体质指数、胰腺质地、胰管直径、术前黄疸、术前经皮经肝胆管引流（PTCD）和术前胆道支架植入等特征。比较两组的阳性胆汁培养率、感染指标（PCT、白细胞计数、CRP、术后发热）,以及术后腹部感染、腹腔出血、迟延胃排空（DGE）、CRPOPF和切口感染的发生率等指标。分析两组的住院时间和费用差异。结果 术后第一天,两组术前的感染指标（PCT、白细胞计数、CRP）均高于术前水平,而组间相比,观察组的水平较低,差异均具有统计学意义。术后,观察组和对照组分别有3例、12例发热,差异具有统计学意义。同时,发热组和正常体温组之间的人口学特征无统计学差异（P>0.05）。而术中胆汁培养阳性率发热组要高于正常体温组（P<0.05）。此外,观察组的阳性胆汁培养率也要高于对照组。在术后并发症方面,切口感染、腹部感染、迟延胃排空（DGE）和腹腔出血的发生率在两组之间具有统计学差异,而其他术后并发症发生率无显著差异。观察组的住院时间较短,住院费用较低（P<0.05）。结论 预防性使用广谱抗菌药在减少胰十二指肠切除术后的并发症,包括切口感染、腹部感染、迟延胃排空（DGE）和腹腔出血方面有一定效果,并能改善患者的预后,缩短住院时间和减少住院费用。

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