Risk factors for postoperative organ/space surgical site infections in hepatic resection

Abstract

Hepatic resection is an invasive operation that can cause severe physiological stress responses and postoperative complications such as surgical site infection (SSI). Postoperative SSI is still one of the most common complications. We reported risk factors for postoperative organ/space SSIs after hepatic resection. We retrospectively examined and analyzed the results of organ/space SSI in 782 patients who underwent liver resection without biliary or enteric resection or reconstruction. Thirty ─one (4.0％) patients had superficial incisional SSIs, fifteen (1.9％) had deep in-cisional SSIs, 130 (16.6％) patients had organ/space SSIs. Of the 130 patients in the organ/space SSIs group, 61 (46.9％) patients had postoperative bile leakage, 32 (24.6％）in infected ascites, 31 (23.8％) in abscess in the tran-section line, 4 (3.1％) in gastrointestinal perforation, and 2 (1.5％) in postoperative abdominal bleeding. Multivari-ate analysis demonstrated five independent risk factors that significantly correlated with postoperative bile leakage: (1) albumin ＜4.0 g/dL (P＜0.001; odds ratio [OR] 2.507 ; 95％ confidence interval [CI] 1.519-4.210), (2) open hepatectomy (P=0.004; OR 2.724; 95％ CI 1.370-5.629), (3) central segmentectomy (P=0.021; OR 2.542; 95％ CI 1.147-5.610), (4) operative time＞300 min (P＜0.001; OR 2.659; 95％ CI 1.567-4.511), and (5) any intraoperative bile leakage (P＜0.001; OR 4.902; 95％ CI 2.725-8.820). Despite developments in surgical techniques and periopera-tive care, organ/space SSIs decrease QOL of the patients and increase the demerit of the medical side. The preven-tion of organ/space SSI following hepatic surgery is very important, and we reported risk factors for postoperative organ/space SSIs after hepatic resection.