Perioperative Synbiotics Decrease Postoperative Complications in Periampullary Neoplasms: A Randomized, Double-Blind Clinical Trial

Periampullary neoplasms are rapidly progressive tumors with a poor prognosis and high morbidity and mortality rates, which have a negative influence on patient outcomes. Some probiotics and prebiotics have the ability to protect the intestinal barrier and prevent bacterial translocation, infection, and postoperative complications. We evaluated the use of synbiotics in a prospective, double-blind study of patients undergoing surgery for periampullary neoplasms (PNs) and assessed the effect of these agents on nutritional status, postoperative complications, antibiotic use, length of hospital stay, and mortality. Patients were randomized to receive probiotics and prebiotics–synbiotics—group S [Lactobacillus acidophilus 10, 1 × 109CFU, Lactobacillus rhamnosus HS 111, 1 × 109 CFU, Lactobacillus casei 10, 1 × 109 CFU, Bifidobacterium bifidum, 1 × 109CFU, and fructooligosaccharides (FOS) 100 mg]—or placebo–controls—group C, twice daily, for a total of 14 days. Risk, clinical status, and postoperative complicatio...