Abstract
Pancreatic ductal adenocarcinoma (PDAC) is an aggressive disease with an extremely poor prognosis. The most common complications after a pancreaticoduodenectomy (PD) include surgical site infection (SSI), postoperative pancreatic fistula (POPF), and delayed gastric emptying (DGE). The potential role and mechanisms of microbial colonization of key surgical sites resulting in perioperative complications after PD remain to be fully elucidated. In this key paper evaluation, the role of different microbiota in perioperative morbidity and mortality following PD are discussed, and key microbial signatures are identified that may shape the future management of post-operative surgical care.