| Project/Area Number |
17K16583
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| Research Category |
Grant-in-Aid for Young Scientists (B)
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| Allocation Type | Multi-year Fund |
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| Research Field |
Digestive surgery
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| Research Institution | Tokyo Medical University |
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Principal Investigator |
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| Project Period (FY) |
2017-04-01 – 2023-03-31
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| Project Status |
Completed (Fiscal Year 2022)
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| Budget Amount *help |
¥2,470,000 (Direct Cost: ¥1,900,000、Indirect Cost: ¥570,000)
Fiscal Year 2019: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000)
Fiscal Year 2018: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000)
Fiscal Year 2017: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
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| Keywords | 細菌感染 / 膵液瘻 / 細菌 / 胆管炎 / 感染 / 細菌培養 / 遺伝子亜型 / 膵頭十二指腸切除 |
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| Outline of Final Research Achievements |
Pancreaticoduodenectomy for biliopancreatic diseases has been on the increase in recent years, and the incidence of pancreatic fistula, an important complication, is still as high as 10-20%. The cause of this complication is thought to be related to bacterial infection of the ascites fluid in addition to leakage of pancreatic juice from the pancreatic jejunal anastomosis.
In this study, we examined the bacteria in the ascitic fluid after surgery, and suggested that preoperative biliary drainage and biliary infection were related. The results of preoperative and postoperative biliary bacteria cultures suggested that the antibiotic susceptibility of bacteria may change and that perioperative use of appropriate antibiotics may prevent ascites infection and reduce pancreatic fistulas.
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| Academic Significance and Societal Importance of the Research Achievements |
今後も増加していくことが予想される胆膵疾患における膵頭十二指腸切除術の重要な合併症である膵液瘻の原因検索，対策を講じることが重要である．手術手技は当然のことながら周術期の管理も重要であり膵液瘻には術後腹水細菌感染が関連しており，術後腹水中の細菌を調べることで周術期に適切な抗生剤を使用することで膵液瘻を減少させる可能性が示唆された．
周術期感染制御による膵液瘻防止策は，これまでにない新たなストラテジーであり，これらの結果は，外科医にとって，今後の膵切除術後合併症対策を行っていく上で，極めて重要なデータになり今後も引き続きデータの集積・解析が必要と考えられる．
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