The Association of Microbiome in Pancreatic Cancer Patients and Postoperative Complication after Pancreatic Resection

INTRODUCTION: Recently it has come into focus that there may be a correlation between the development of postoperative complication and the patient’s individual microbiome in pancreatic operations. The aim of this review is to examine whether bacterial communities found in intraoperative swabs of patients undergoing pancreatic resection are linked to complication after pancreatic operation. METHODS: PubMed Central, Google scholar, and the Web of Science were searched systematically with microbiome AND pancreatic cancer OR pancreatectomy OR Whipple’s procedure OR duodenopancreatectomy as search terms. Primary outcomes measure was postoperative complication. Studies about nonsurgical patients, microbiome samples of tumor specimens, and nonintraoperative swabs were excluded. RESULTS: Initial search yielded 141 publications. After review of the abstracts, 16 studies with a total number of 1,777 patients were extracted for full paper scan using the criteria of postoperative outcomes as parameter. Eventually, 6 studies with a total patient number of 794 were included in the review. Of these 3 were designed prospectively and 3 were retrospective analyses with 1 being a multicenter analysis. All studies found a relation between bacteriobilia and an increased incidence of pancreatic secretion and fistulas postoperatively with only 1 prospective study confirming a relation between bacteriobilia and postoperative pancreatic fistulas in vivo with patients who exerted bacteriobilia having a 2-fold higher risk for postoperative fistula development as compared with others. CONCLUSION: A relation between postoperative complication after pancreatic resection and bacteriobilia seems to exist. However, this field desperately lacks prospective studies to draw real conclusions and yield therapeutic options.