Synbiotics in Surgery for Chronic Pancreatitis
Synbiotics in Surgery for Chronic Pancreatitis
Four patients (all 4 in group B) were excluded from the study after randomization because Frey procedure was not possible due to the presence of active pancreatitis and extensive collaterals channels over the pancreas. All the other 75 randomized patients [group A (n = 39) and group B (n = 36)] completed the study. The 2 groups were homogenous with regard to demographic data; there were no differences in the age, sex, and American Society of Anesthesiologists classification between the 2 groups (Table 1).
The mean laboratory values including hemoglobin, total leukocyte count, blood urea nitrogen, serum bilirubin, and serum albumin on postoperative period days 1, 5, and 10 did not differ significantly throughout the 2 groups (Table 2).
In group A, 12.8% of the patients and in group B, 39% of patients had infectious complications. Wound infections (n = 3) and respiratory infections (n = 2) were observed in patients who were administered synbiotic. Whereas in group B, apart from wound infection (n = 8) and respiratory infection (n = 3), urinary tract infection (n = 2) and sepsis (n = 1) were also observed. All infections were treated with antibiotics. This difference was statistically significant (P = 0.05) (Table 3 and Fig. 2) Most of the isolated bacteria were gut-derived, with a predominance of Klebsiella pneumonia and Escherichia coli.
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Figure 2.
Infectious Complications.
There were no significant differences in the mean operating times, blood loss, first bowel movement, and intensive care unit stay between the 2 groups. The mean total length of hospital stay was shorter in group A (8.4 ± 2.9) than that in group B (17.9 ± 5.2). The duration of antibiotic intake was also shorter in group A (2.4 ± 4.8) than that in group B (10.8 ± 3.3); these differences were statistically significant (P < 0.05) (Table 4 and Fig. 3).
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Figure 3.
Postoperative Variables. ICU indicates intensive care unit.
Synbiotic combinations were well tolerated in all patients.
Results
Demographic and Operative Data
Four patients (all 4 in group B) were excluded from the study after randomization because Frey procedure was not possible due to the presence of active pancreatitis and extensive collaterals channels over the pancreas. All the other 75 randomized patients [group A (n = 39) and group B (n = 36)] completed the study. The 2 groups were homogenous with regard to demographic data; there were no differences in the age, sex, and American Society of Anesthesiologists classification between the 2 groups (Table 1).
Laboratory Parameters
The mean laboratory values including hemoglobin, total leukocyte count, blood urea nitrogen, serum bilirubin, and serum albumin on postoperative period days 1, 5, and 10 did not differ significantly throughout the 2 groups (Table 2).
Postoperative Bacterial Infections
In group A, 12.8% of the patients and in group B, 39% of patients had infectious complications. Wound infections (n = 3) and respiratory infections (n = 2) were observed in patients who were administered synbiotic. Whereas in group B, apart from wound infection (n = 8) and respiratory infection (n = 3), urinary tract infection (n = 2) and sepsis (n = 1) were also observed. All infections were treated with antibiotics. This difference was statistically significant (P = 0.05) (Table 3 and Fig. 2) Most of the isolated bacteria were gut-derived, with a predominance of Klebsiella pneumonia and Escherichia coli.
(Enlarge Image)
Figure 2.
Infectious Complications.
Length of Hospital Stay and Antibiotic Therapy
There were no significant differences in the mean operating times, blood loss, first bowel movement, and intensive care unit stay between the 2 groups. The mean total length of hospital stay was shorter in group A (8.4 ± 2.9) than that in group B (17.9 ± 5.2). The duration of antibiotic intake was also shorter in group A (2.4 ± 4.8) than that in group B (10.8 ± 3.3); these differences were statistically significant (P < 0.05) (Table 4 and Fig. 3).
(Enlarge Image)
Figure 3.
Postoperative Variables. ICU indicates intensive care unit.
Side Effects of Synbiotics
Synbiotic combinations were well tolerated in all patients.
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