{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T05:09:25Z","timestamp":1747199365396,"version":"3.40.5"},"reference-count":86,"publisher":"Akademiai Kiado Zrt.","issue":"1","license":[{"start":{"date-parts":[[2022,3,24]],"date-time":"2022-03-24T00:00:00Z","timestamp":1648080000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["akjournals.com"],"crossmark-restriction":true},"short-container-title":["MaSeb"],"published-print":{"date-parts":[[2022,3,24]]},"abstract":"\n Bevezet\u00e9s<\/jats:title>\n Pankre\u00e1szfejtumorok k\u00f6vetkezt\u00e9ben kialakult elz\u00e1r\u00f3d\u00e1sos s\u00e1rgas\u00e1g miatt gyakran preoperat\u00edv epe\u00fati sztent ker\u00fcl behelyez\u00e9sre, ez azonban sz\u00f6v\u0151dm\u00e9ny forr\u00e1sa is lehet.<\/jats:p>\n <\/jats:sec>\n \n Anyag \u00e9s m\u00f3dszer<\/jats:title>\n Retrospekt\u00edv m\u00f3don elemezt\u00fck az oszt\u00e1lyunkon 2017. 10. 01. \u00e9s 2019. 12. 31. k\u00f6z\u00f6tti id\u0151szakban pankre\u00e1sztumor miatt v\u00e9gzett m\u0171t\u00e9teinket a preoperat\u00edv sztenttel \u00f6sszef\u00fcgg\u0151 mortalit\u00e1s \u00e9s morbidit\u00e1s tekintet\u00e9ben. Vizsg\u00e1ltuk a multirezisztens bakt\u00e9riumok \u00e9s a m\u0171t\u00e9ti epemint\u00e1ban el\u0151fordul\u00f3 k\u00f3rokoz\u00f3k spektrum\u00e1t.<\/jats:p>\n <\/jats:sec>\n \n Eredm\u00e9nyek<\/jats:title>\n Nyolcvan\u00f6t betegn\u00e9l t\u00f6rt\u00e9nt pankre\u00e1sztumor miatt m\u0171t\u00e9t, ebb\u0151l 63 pankre\u00e1szfej reszekci\u00f3, 3 diszt\u00e1lis reszekci\u00f3, 19 palli\u00e1ci\u00f3. A 63 fejreszekci\u00f3n \u00e1tesett beteg adatait elemezt\u00fck. 31 esetben nyitott, 4 esetben laparoszk\u00f3pos konvert\u00e1lt, m\u00edg 28 esetben laparoszk\u00f3pos m\u0171t\u00e9tet v\u00e9gezt\u00fcnk. A 36 sztentelt beteg k\u00f6z\u00fcl 24 f\u00e9rfi (\u00e1tlag\u00e9letkoruk 65,0 \u00e9v) \u00e9s 12 n\u0151 (\u00e1tlag\u00e9letkoruk 64,0 \u00e9v) volt. A 27 nem sztentelt beteg k\u00f6z\u00fcl 14 f\u00e9rfi (\u00e1tlag\u00e9letkoruk 67,9 \u00e9v) \u00e9s 13 n\u0151 (\u00e1tlag\u00e9letkoruk 58 \u00e9v) volt. A sztentelt csoportban az epeteny\u00e9szt\u00e9s 30\/36 (83%), m\u00edg a nem sztentelt csoportban 13\/27 (48%) esetben bizonyult pozit\u00edvnak (P<\/jats:italic> = 0,005). A h\u00e1rom leggyakrabban el\u0151fordul\u00f3 bakt\u00e9rium mindk\u00e9t csoportban az Escherichia coli<\/jats:italic>, Enterococcus faecalis<\/jats:italic>, Klebsiella pneumonie<\/jats:italic> voltak, ezt k\u00f6vette a Candida gomba el\u0151fordul\u00e1sa. A sztentelt csoportban 8 esetben multirezisztens bakt\u00e9rium el\u0151fordul\u00e1s\u00e1t is \u00e9szlelt\u00fck (22,2%). Hat ESBL-termel\u0151 bakt\u00e9rium (P<\/jats:italic> = 0,033) \u00e9s 2 VRE (vancomycin rezisztens t\u00f6rzs) (P<\/jats:italic> = 0,5) volt. A sztentelt csoportb\u00f3l 3, a nem sztentelt csoportb\u00f3l 2 beteget vesz\u00edtett\u00fcnk el 30 napon bel\u00fcl. A sz\u00f6v\u0151dm\u00e9nyek k\u00f6z\u00fcl a sztentelt-nem sztentelt csoportokban a sebfert\u0151z\u00e9s 4\/0, v\u00e9rz\u00e9s 6\/2, pankre\u00e1szsipoly 2\/2 \u00e9s has\u00fcregi t\u00e1lyog 2\/3 ar\u00e1nyban fordultak el\u0151. Az \u00e1tlagos \u00e1pol\u00e1si id\u0151 a sztentelt csoportban 19,47, a nem sztentelt csoportban 14,62 nap volt (P<\/jats:italic> = 0,14).<\/jats:p>\n <\/jats:sec>\n \n Konkl\u00fazi\u00f3<\/jats:title>\n Tekintettel arra, hogy az epe\u00fati sztent megv\u00e1ltoztatja a bakt\u00e9riumfl\u00f3r\u00e1t, fontos az ennek megfelel\u0151 antibiotikus profilaxis megv\u00e1laszt\u00e1sa a morbidit\u00e1s cs\u00f6kkent\u00e9s\u00e9re. Eredm\u00e9nyeink \u00e9s az irodalom alapj\u00e1n is enterococcus \u00e9s ESBL-termel\u0151 t\u00f6rzs ellen is hat\u00e1sos antibiotikum javasolt. A gomba elleni profilaxis megfontoland\u00f3, k\u00fcl\u00f6n\u00f6sen immunszupprim\u00e1lt esetben. Javasolt tov\u00e1bb\u00e1 az antibiotikus rezisztencia folyamatos k\u00f6vet\u00e9se.<\/jats:p>\n <\/jats:sec>","DOI":"10.1556\/1046.2021.10001","type":"journal-article","created":{"date-parts":[[2022,3,25]],"date-time":"2022-03-25T08:24:43Z","timestamp":1648196683000},"page":"1-7","update-policy":"https:\/\/doi.org\/10.1556\/policypage.crossmark.crossref.1","source":"Crossref","is-referenced-by-count":0,"title":["A preoperat\u00edv bili\u00e1ris sztent hat\u00e1sa a posztoperat\u00edv sz\u00f6v\u0151dm\u00e9nyekre hasny\u00e1lmirigyfej-daganat miatt v\u00e9gzett reszekci\u00f3s m\u0171t\u00e9teink kapcs\u00e1n"],"prefix":"10.1556","volume":"75","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0670-3773","authenticated-orcid":true,"given":"Korn\u00e9lia","family":"Trep\u00e1k","sequence":"first","affiliation":[{"name":"B\u00e1cs-Kiskun Megyei Oktat\u00f3k\u00f3rh\u00e1z, \u00c1ltal\u00e1nos Seb\u00e9szeti Oszt\u00e1ly, Kecskem\u00e9t, Magyarorsz\u00e1g (oszt\u00e1lyvezet\u0151: prof. dr. Sikorszki L\u00e1szl\u00f3)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Korn\u00e9l","family":"Vajda","sequence":"additional","affiliation":[{"name":"B\u00e1cs-Kiskun Megyei Oktat\u00f3k\u00f3rh\u00e1z, \u00c1ltal\u00e1nos Seb\u00e9szeti Oszt\u00e1ly, Kecskem\u00e9t, Magyarorsz\u00e1g (oszt\u00e1lyvezet\u0151: prof. dr. Sikorszki L\u00e1szl\u00f3)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Em\u0151ke","family":"Albert","sequence":"additional","affiliation":[{"name":"B\u00e1cs-Kiskun Megyei Oktat\u00f3k\u00f3rh\u00e1z, \u00c1ltal\u00e1nos Seb\u00e9szeti Oszt\u00e1ly, Kecskem\u00e9t, Magyarorsz\u00e1g (oszt\u00e1lyvezet\u0151: prof. dr. Sikorszki L\u00e1szl\u00f3)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ildik\u00f3","family":"Horti","sequence":"additional","affiliation":[{"name":"B\u00e1cs-Kiskun Megyei Oktat\u00f3k\u00f3rh\u00e1z, \u00c1ltal\u00e1nos Seb\u00e9szeti Oszt\u00e1ly, Kecskem\u00e9t, Magyarorsz\u00e1g (oszt\u00e1lyvezet\u0151: prof. dr. Sikorszki L\u00e1szl\u00f3)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L\u00e1szl\u00f3","family":"Sikorszki","sequence":"additional","affiliation":[{"name":"B\u00e1cs-Kiskun Megyei Oktat\u00f3k\u00f3rh\u00e1z, \u00c1ltal\u00e1nos Seb\u00e9szeti Oszt\u00e1ly, Kecskem\u00e9t, Magyarorsz\u00e1g (oszt\u00e1lyvezet\u0151: prof. dr. Sikorszki L\u00e1szl\u00f3)"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"425","reference":[{"key":"ref261","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1097\/00000658-193510000-00023","article-title":"Treatment of carcinoma of the ampulla of Vater","volume":"102","author":"Whipple","year":"1935","journal-title":"Ann Surg"},{"key":"ref151","doi-asserted-by":"crossref","first-page":"2364","DOI":"10.1007\/s00464-010-1552-6","article-title":"Biliary metal stents are superior to plastic stents for preoperative biliary decompression in pancreatic cancer","volume":"25","author":"Decker","year":"2011","journal-title":"Surg Endosc"},{"key":"ref61","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/0002-9610(81)90296-8","article-title":"Experimental and clinical studies on the effect of biliary drainage in obstructive jaundice","volume":"142","author":"Koyama","year":"1981","journal-title":"Am J Surg"},{"key":"ref671","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/j.surg.2013.03.016","article-title":"Current trends in preoperative biliary stenting in patients with pancreatic cancer","volume":"154","author":"Jinkins","year":"2013","journal-title":"Surgery"},{"key":"ref481","first-page":"343","article-title":"Effects of biliary endoprostheses on the extrahepatic bile ducts in relation to subsequent operation of the biliary tract","volume":"178","author":"Karsten","year":"1994","journal-title":"J Am Coll Surg"},{"key":"ref501","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1016\/S1072-7515(01)00819-5","article-title":"The effect of preoperative biliary drainage on postoperative complications after pancreaticoduodenectomy","volume":"192","author":"Sewnath","year":"2001","journal-title":"J Am Coll Surg"},{"key":"ref621","doi-asserted-by":"crossref","first-page":"6847","DOI":"10.3748\/wjg.v25.i47.6847","article-title":"Influence of bile contamination for patients who undergo pancreaticoduodenectomy after biliary drainage","volume":"25","author":"Okano","year":"2019","journal-title":"World J Gastroenterol"},{"key":"ref791","doi-asserted-by":"crossref","first-page":"2230","DOI":"10.1007\/s00268-007-9210-4","article-title":"Specific antibiotic prophylaxis based on bile cultures is required to prevent postoperative infectious complications in pancreatoduodenectomy patients who have undergone preoperative biliary drainage","volume":"31","author":"Sudo","year":"2007","journal-title":"World J Surg"},{"key":"ref51","first-page":"343","article-title":"Effects of biliary endoprostheses on the extrahepatic bile ducts in relation to subsequent operation of the biliary tract","volume":"178","author":"Karsten","year":"1994","journal-title":"J Am Coll Surg"},{"key":"ref321","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.ijsu.2010.10.008","article-title":"Pre-operative stenting is associated with a higher prevalence of post-operative complications following pancreatoduodenectomy","volume":"9","author":"Morris-Stiff","year":"2011","journal-title":"Int J Sur"},{"key":"ref181","first-page":"374","article-title":"Relationship between bile colonization, high-risk factors and postoperative sepsis in patients undergoing biliary tract operations while receiving a prophylactic antibiotic. 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pancreaticoduodenectomy: a large single center experience from the Massachusetts General Hospital","volume":"23","author":"Sahora","year":"2016","journal-title":"J Hepato-biliary-pancreatic Sci"},{"key":"ref531","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1016\/j.surg.2016.11.014","article-title":"The 2016 update of the International Study Group (ISGPS) definition and grading of postoperative pancreatic fistula: 11 Years after","volume":"161","author":"Bassi","year":"2017","journal-title":"Surgery"},{"key":"ref711","doi-asserted-by":"crossref","first-page":"22741","DOI":"10.1097\/MD.0000000000022714","article-title":"The effect of preoperative biliary stents on outcomes after pancreaticoduodenectomy: a meta-analysis","volume":"99","author":"Gong","year":"2020","journal-title":"Medicine"},{"key":"ref601","doi-asserted-by":"crossref","first-page":"1278","DOI":"10.1016\/j.ejso.2016.05.001","article-title":"Systematic review and meta-analysis of metal versus plastic stents 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infectious complications in pancreaticoduodenectomy and directs antimicrobial prophylaxis: an antibiotic stewardship strategy?","volume":"20","author":"De Pastena","year":"2018","journal-title":"HPB"},{"key":"ref721","doi-asserted-by":"crossref","first-page":"e182","DOI":"10.1002\/bjs.10450","article-title":"Effect of preoperative biliary drainage on bacterial flora in bile of patients with periampullary cancer","volume":"104","author":"Scheufele","year":"2017","journal-title":"Br J Surg"},{"key":"ref161","doi-asserted-by":"crossref","first-page":"8638","DOI":"10.3748\/wjg.v19.i46.8638","article-title":"Randomized trial in malignant biliary obstruction: plastic vs partially covered metal stents","volume":"19","author":"Moses","year":"2013","journal-title":"World J Gastroenterol"},{"key":"ref581","doi-asserted-by":"crossref","first-page":"2364","DOI":"10.1007\/s00464-010-1552-6","article-title":"Biliary metal stents are superior to plastic stents for preoperative biliary decompression in pancreatic cancer","volume":"25","author":"Decker","year":"2011","journal-title":"Surg Endosc"},{"key":"ref141","doi-asserted-by":"crossref","first-page":"e1199","DOI":"10.1097\/MD.0000000000001199","article-title":"Effect of preoperative biliary drainage on complications following pancreatoduodenectomy","volume":"94","author":"Chen","year":"2015","journal-title":"Medicine (Baltimore)"},{"key":"ref371","doi-asserted-by":"crossref","first-page":"1437","DOI":"10.1556\/650.2019.31456","article-title":"Az antibiotikumrezisztencia v\u00e1ltoz\u00e1sa cholangitisben. Klinikai tapasztalataink","volume":"160","author":"Ill\u00e9s","year":"2019","journal-title":"Orv Hetil"},{"key":"ref41","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1002\/bjs.1800810839","article-title":"Preoperative endoscopic drainage for malignant obstructive jaundice","volume":"81","author":"Lai","year":"1994","journal-title":"Br J Surg"},{"key":"ref701","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1002\/jhbp.322","article-title":"Preoperative biliary drainage does not increase major complications in pancreaticoduodenectomy: a large single center experience from the Massachusetts General Hospital","volume":"23","author":"Sahora","year":"2016","journal-title":"J Hepato-biliary-pancreatic Sci"},{"key":"ref221","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1016\/S1091-255X(99)80103-6","article-title":"Preoperative biliary drainage: impact on intraoperative bile cultures and infectious morbidity and mortality after pancreaticoduodenectomy","volume":"3","author":"Povoski","year":"1999","journal-title":"J Gastrointest Surg"},{"key":"ref231","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.suc.2017.09.005","article-title":"Preoperative stenting for benign and malignant periampullary diseases: unnecessary if not harmful","volume":"98","author":"Gholami","year":"2018","journal-title":"Surg Clin North Am"},{"key":"ref611","first-page":"374","article-title":"Relationship between bile colonization, high-risk factors and postoperative sepsis in patients undergoing biliary tract operations while receiving a prophylactic antibiotic. West of Scotland Surgical Infection Study Group","volume":"76","author":"Wells","year":"1989","journal-title":"Br J Surg"},{"key":"ref251","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1097\/00000658-199908000-00001","article-title":"Association of preoperative biliary drainage with postoperative outcome following pancreaticoduodenectomy","volume":"230","author":"Povoski","year":"1999","journal-title":"Ann Surg"},{"key":"ref851","doi-asserted-by":"crossref","first-page":"2183","DOI":"10.1023\/A:1026640603312","article-title":"Enterococcal bactibilia in patients with malignant biliary obstruction","volume":"45","author":"Nomura","year":"2000","journal-title":"Dig Dis Sci"},{"key":"ref71","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1016\/S1072-7515(01)00819-5","article-title":"The effect of preoperative biliary drainage on postoperative complications after pancreaticoduodenectomy","volume":"192","author":"Sewnath","year":"2001","journal-title":"J Am Coll Surg"},{"key":"ref801","doi-asserted-by":"crossref","first-page":"1437","DOI":"10.1556\/650.2019.31456","article-title":"Az antibiotikumrezisztencia v\u00e1ltoz\u00e1sa cholangitisben. Klinikai tapasztalataink","volume":"160","author":"Ill\u00e9s","year":"2019","journal-title":"Orv Hetil"},{"key":"ref571","doi-asserted-by":"crossref","first-page":"e1199","DOI":"10.1097\/MD.0000000000001199","article-title":"Effect of preoperative biliary drainage on complications following pancreatoduodenectomy","volume":"94","author":"Chen","year":"2015","journal-title":"Medicine (Baltimore)"},{"key":"ref651","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1016\/S1091-255X(99)80103-6","article-title":"Preoperative biliary drainage: impact on intraoperative bile cultures and infectious morbidity and mortality after pancreaticoduodenectomy","volume":"3","author":"Povoski","year":"1999","journal-title":"J Gastrointest Surg"},{"key":"ref351","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1002\/jhbp.518","article-title":"Tokyo Guidelines 2018: antimicrobial therapy for acute cholangitis and cholecystitis","volume":"25","author":"Gomi","year":"2018","journal-title":"J Hepatobiliary Pancreat Sci"},{"key":"ref661","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.suc.2017.09.005","article-title":"Preoperative stenting for benign and malignant periampullary diseases: unnecessary if not harmful","volume":"98","author":"Gholami","year":"2018","journal-title":"Surg Clin North Am"},{"key":"ref561","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1080\/11024150260284815","article-title":"Compromise of immune function in obstructive jaundice","volume":"168","author":"Neh\u00e9z","year":"2002","journal-title":"Eur J Surg"},{"key":"ref81","first-page":"999","article-title":"Appropriate antimicrobial prescribing: approaches that limit antibiotic resistance","volume":"64","author":"Colgan","year":"2001","journal-title":"Am Fam Physician"},{"key":"ref681","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1097\/00000658-199908000-00001","article-title":"Association of preoperative biliary drainage with postoperative outcome 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