Bactibilia in diseases of the biliary tract and pancreatic gland in patients older than 80 years: a STROBE-retrospective cohort study in a teaching hospital in Italy

Bile is a lipid-rich sterile solution produced in the liver that can be infected resulting in bactibilia. A higher incidence of postoperative infectious complications has been seen in patients with bactibilia. Recently, gram-negative bacteria have been linkedtoatumor-associatedinflammatorystatus.Thisstudyisaretrospectivecohortstudyof39patients,whoareover80years ofageonly(53.85%malesand46.15%females),hospitalizedwithdiseasesofthebiliopancreaticsysteminoneteachinghospital inItaly fromJanuary 2011 toDecember2012witha follow-up of5 years.The mostcommonbiliary diseasesafter surgerywere pancreaticheadcancer(p<0.0001)andgallbladdercancer(p=0.0051),whilethemostcommonbacteriainthebilewereE.coli (p=0.0180) and Pseudomonas spp. (p<0.0001). Uni- and multivariate linear correlation analysis revealed that patients with pancreatic head cancer had low survival times compared to patients with other diseases. Moreover, the bacterium type was a positivepredictorofsurvivaltimecomparedtoothervariables.OurdataconfirmE.coliasapathogeninpatientswithgallbladder and pancreatic cancer. Although the influence of bactibilia in developing surgical complications is limited, we consider that its composition is crucial to properly address the antibiotic treatment in biliary tract infections, especially in the elderly.