Abstract
To the Editor:
We would like to share ideas on “Antibiotic-Resistant Bacteria Colonizing the Bile Duct are Associated with Increased Morbidity and Mortality after Resection of Extrahepatic Cholangiocarcinoma” [1]. Cammann et al. [1] report that “Antibiotic-resistant bacteria from the CHD are associated with increased morbidity and mortality in patients undergoing resection for extrahepatic CCA.” We agree that antibiotic-resistant bacterial colonization might occur after resection of cholangiocarcinoma (CCA). In a previous report, the colonization is common, and it should be a concern for adapting antibiotic prophylaxis [2]. However, it should noted that the mortality of CCA after resection depends on several factors including the staging of disease, other concurrent medical conditions, and nutritional background of the patient. Whether the antibiotic resistance is associated with mortality is still a topic for further research. The role of proper antibiotic use is still inconclusive. Antibiotic prophylaxis might help decrease surgical infection. On the other hand, the adverse effect of antibiotic use is also reported and might be associated with increased mortality [3].