High Rate of Organ/Space Surgical Site Infection After Hepatectomy with Preexisting Bilioenteric Anastomosis View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2015-11-16

AUTHORS

Masaru Matsumura, Akio Saiura, Yosuke Inoue, Takeaki Ishizawa, Yoshihiro Mise, Yu Takahashi

ABSTRACT

BackgroundThe clinical course of hepatectomy in patients with preexisting bilioenteric anastomosis (BEA) is poorly understood. The aim of this study was to evaluate the potential influence of preexisting BEA on organ/space surgical site infection (SSI) after hepatectomy.MethodsWe analyzed consecutive hepatectomies performed between March 2005 and January 2015. Patients’ background, operative results, and complications were compared between hepatectomies with and without preexisting BEA.ResultsTwenty-two hepatectomies with preexisting BEA were identified among 1745 hepatectomies. The rate of organ/space SSI was much higher in hepatectomies with preexisting BEA than in those without preexisting BEA (40.9 vs. 6.4 %, P < 0.001). Multivariate analyses identified four variables as independent factors associated with organ/space SSI: liver-directed chemotherapy [odds ratio 5.06 (95 % confidence interval 2.29–10.54), P < 0.001], operative time ≥ 300 min [2.40 (1.30–4.54), P = 0.006], estimated blood loss ≥ 500 ml [2.34 (1.26–4.31), P < 0.001], and preexisting BEA [12.08 (4.54–31.32), P < 0.001]. A higher rate of organisms from intestinal flora was detected in organ/space SSI after hepatectomies with preexisting BEA (77.8 vs. 21.3 % without BEA, P = 0.002). Analysis of hepatectomies with preexisting BEA identified selection of antibiotics for prophylaxis as the sole risk factor for organ/space SSI (P = 0.049 for cefazolin versus other antibiotics targeting intestinal flora).ConclusionsPreexisting BEA is an independent risk factor for the development of organ/space SSI after hepatectomy. Antibiotics targeting intestinal flora are strongly recommended for prophylaxis of infectious complications. More... »

PAGES

937-945

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URI

http://scigraph.springernature.com/pub.10.1007/s00268-015-3340-x

DOI

http://dx.doi.org/10.1007/s00268-015-3340-x

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1016144113

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/26573175


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