Objective:

To evaluate the resistance profile of biliary bacteria and its impact on liver-specific complications, particularly bile leak, after resection of perihilar cholangiocarcinoma.

Approach:

• Study Design: Retrospective, single-center, observational study including patients with perihilar cholangiocarcinoma who underwent curative resection.
• Data Collection: Demographic and clinical data were collected from electronic patient records, including surgical procedures and postoperative complications.
• Microbiological Analysis: Bile duct cultures were obtained and analyzed for microbial spectrum and antibiotic susceptibility.
• Statistical Analysis: Data were analyzed for correlation between antibiotic-resistant bacteria and liver-specific complications using appropriate statistical tests.

Key Findings:

• A total of 118 patients were included, with a median age of 67 years.
• Microorganisms were detected in 93 of the bile swab samples (89.4%).
• 67.3% of samples were positive for Gram-positive bacteria, and 52.9% for Gram-negative bacteria.
• 78.8% of patients received postoperative antimicrobial therapy.

Interpretation:

The study reports a high prevalence of antibiotic-resistant bacteria in biliary colonization and explores its association with liver-specific complications post-surgery.

Limitations:

• Single-center study may limit generalizability.
• Retrospective design may introduce selection bias.

Conclusion:

The presence of antibiotic-resistant bacteria in biliary cultures may be associated with increased liver-specific complications, particularly bile leak, after resection of perihilar cholangiocarcinoma.