BACKGROUND AND OBJECTIVES

Hepatobiliarypancreatic tuberculosis (HBPTB) is a less common form of tuberculosis that often presents as malignancy or lithiasis. Advances in diagnostics and minimally invasive procedures have led to the detection of more patients with milder forms of TB requiring surgical management. Due to the low incidence rates and lack of standardized approaches, additional studies are needed to improve patient outcomes. This study examined the risk factors, diagnostic methods, and treatments for HBPTB patients at the University of the Philippines – Philippine General Hospital (UP-PGH) from January 1, 2014 to December 31, 2021.

METHODS

This retrospective descriptive study utilized our institutional database to identify patients who underwent a surgical procedure for HBPTB and their associated risk factors. Inclusion criteria required biopsy or microbiologic proof of tuberculous involvement of the biliary tract or nearby structures.

RESULTS

Among a total of 45 patients, the most common admitting diagnosis were HBP tuberculosis (37.8%) and malignancy (35.6%). 47.6% of patients had a previous or concurrent TB exposure. Sixty percent had subclinical malnutrition indicated by normal weight and low albumin. The liver (37.8%) and the bile ducts (33.3%) were the most common organs involved. The most common surgical procedures done were ultrasound-guided liver biopsy, biliary enteric anastomosis, percutaneous transhepatic biliary drainage (PTBD), and endoscopic retrograde cholangiopancreatography with or without stenting (ERCP).

CONCLUSIONS

This study provides additional data for clinicians to tailor diagnostic and treatment plans accordingly. Striking a balance between surgical procedures and appropriate anti-tuberculous therapy (ATT) is essential for successful treatment. Local data can be useful to help identify tuberculosis patterns unique to Filipinos and highlight socio-economic factors contributing to this rare presentation of TB.

Human ; Tuberculosis, Extrapulmonary ; Biliary Tract Diseases ; General Surgery ; Acute Care Surgery ; Liver Diseases ; Pancreas

RATIONALE/OBJECTIVE

This study aimed to determine the knowledge, attitudes and practices of surgeons and surgical trainees regarding published SSI prevention guidelines. Specifically, the study described knowledge and attitudes towards SSI prevention guidelines among members of surgical training programs, described preoperative, intraoperative, and postoperative practices in SSI prevention and identified the presence of surgical site infection surveillance programs among various institutions.

METHODS

This was a retrospective cross-sectional study that evaluated the knowledge, attitudes, and practices of surgeons and surgical trainees to published SSI prevention guidelines in the Philippines. It utilized existing data from an October 2022 online survey done by the Philippine College of Surgeons distributed to various surgical training institutions in the country.

RESULTS

There were a total of 213 respondents. The different attitudes and knowledge gaps towards present SSI prevention guidelines are described.

CONCLUSION

Despite the existence of local and international guidelines there still appears to be a significant lack of awareness and variability in practice among the different institutions as well as with surgeons of different levels of expertise or training. Varying preoperative, intraoperative and postoperative practices have also been described, including evident deviations from SSI guidelines. Lastly, there is a lack of standardized SSI surveillance programs among institutions and these are not aligned towards improved patient safety and quality improvement.

Human ; Surgical Wound Infection