Probiotics reduce infectious complications after pancreaticoduodenectomy

BACKGROUND/AIMS: Postoperative morbidity is a significant problem associated with pancreaticoduodenectomy. The clinical value of probiotics in surgical patients remains unclear. This study investigated the effect of probiotics on surgical outcome after pancreaticoduodenectomy. METHODOLOGY: Seventy patients with pancreaticobiliary diseases were randomly allocated to two groups before pancreaticoduodenectomy, one of which received probiotics perioperatively and the other served as controls. Postoperative infectious complications were recorded. RESULTS: Of the 70 patients, 64 completed the trial (30 receiving probiotics and 34 controls). The probiotics used in the study contained Enterococcus faecalis T-110, Clostridium butyricum TO-A, and Bacillus mesentericus TO-A. The probiotics were first administered immediately after admission, 3 to 15 days before the operation, and then reintroduced on the second postoperative day. They were continued until hospital discharge. Infectious complications occurred after pancreaticoduodenectomy in 25 patients (39%). The incidence of infectious complications in the probiotics group (23%, 7/30) was significantly lower than in controls (53%, 18/34) (P = 0.02). Mortality amongst all patients was 1.6% (1 patient in the control group). CONCLUSIONS: The use of perioperative probiotics reduced postoperative infectious complications after pancreaticoduodenectomy, making it a promising potential adjunct therapy for patients undergoing high-risk hepato, biliary, and pancreatic surgery.