Preoperative Risk Factor Analysis and Prognosis of Sepsis After Elective Hepatobiliary and Pancreatic Surgery

Abstract

PURPOSE: We aimed to analyze the risk factor of sepsis after hepatobiliary and pancreatic surgery and to investigate the prognosis. METHODS：The subjects were retrospectively studied from the database for hepatobiliary and pancreatic surgery cases, who had undergone a surgical operation at Tohoku University Hospital and Tohoku Rosai Hospital from 2011 to 2015. RESULTS：A total of 523 cases were reviewed. The sepsis rates were 6％, 16％, 10％, 33％ and 56％ in pancreaticoduodenectomy (PD), hepatectomy, total pancreatectomy, distal pancreatectomy combined with celiac axis resection, and hepato-pancreaticoduodenectomy, respectively. In the PD group, it was found that the low value of hemoglobin was a risk factor, and in the hepatectomy group, a prolonged activated partial thromboplastin time (APTT) was a risk factor. Regarding the long-term prognosis, when the overall survival rate was examined except for 90-day mortality with sepsis cases and benign diseases, sepsis cases showed a poor prognosis in the hepatectomy group. CONCLUSIONS: Because sepsis might have a relationship with the long-term prognosis, highly invasive surgery for hepatobiliary and pancreatic surgery requires postoperative management based on the preoperative risk factors with sepsis in mind.