To explore the related factors and pathogen composition of complicated intra-abdominal infection (cIAI) after pancreaticoduodenectomy (PD), providing evidence for the prevention of cIAI after PD.

From January 2010 to January 2020, 89 patients with cIAI after PD were retrospectively collected as the infectious group in General Hospital of Ningxia Medical University. According to the inclusion criteria, 91 patients without cIAI after PD were collected as the control group by equidistant random sampling at a ratio of about 1∶1. The pathogen composition was described statistically according to the results of bacterial culture of the drainage fluid in the infection group. The risk factors of cIAI after PD were analyzed by single- and multi-variate Logistic regression analysis. Preoperative biliary drainage (OR=6.569, 95% CI: 1.178-14.630), operation time ≥ 6 h (OR=6.872, 95% CI: 2.258-20.913) and pancreatic fistula (OR=3.426, 95% CI: 1.219-9.631) were the risk factors for cIAI after PD (all P<0.05). There were 28 varieties of cultivated strains. The majority of gram-negative bacteria were Escherichia coli, Enterobacter cloacae and Klebsiella pneumoniae, the total composition ratio was 50.00%. Enterococcus faecium was the major Gram-positive bacteria, with a composition ratio of 52.17%; and Candida albicans is the most common fungus (92.86%).

The occurrence of cIAI after PD is critical. Rational preoperative biliary drainage and shortening surgery time are particularly vital for the prevention of cIAI. Comprehensive treatment with antibiotics should be carried out in a timely and reasonable manner.