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Karger Publishers, Digestive Surgery, 3(35), p. 204-211, 2017

DOI: 10.1159/000477777

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Surgical Site Infection after Hepatectomy for Hepatocellular Carcinoma

This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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Abstract

<b><i>Aims:</i></b> To clarify the clinical impact, risk factors, and preventive methods for surgical site infection (SSI) after hepatectomy for hepatocellular carcinoma (HCC). <b><i>Methods:</i></b> We included 879 consecutive patients who underwent hepatectomy for HCC between 2002 and 2011. Univariate and multivariate analyses were conducted to identify the risk factors for incisional and organ/space SSIs. ORs and 95% CIs are reported. <b><i>Results:</i></b> The incidences of incisional and organ/space SSIs were 24 (2.7%) and 73 (8.3%), respectively. High body mass index, multiple resections, and organ/space SSI were associated with incisional SSIs, while repeat hepatectomy (OR 2.14, 95% CI 1.27-3.60), ascites (OR 2.97, 95% CI 1.55-5.48), and bile leakage (OR 4.77, 95% CI 2.77-8.11) were independent risk factors for organ/space SSI. Among the cases with bile leakage, lower rates of organ/space SSIs tended to be observed in patients with cystic duct tubes than in patients without such tubes (13.2 vs. 26.5%, <i>p</i> = 0.157). Retrograde drain infections increased when drain placement was prolonged for more than 4 postoperative days. <b><i>Conclusion:</i></b> Bile leakage was associated with the greatest risk of organ/space SSI after hepatectomy for HCC. Cystic duct tubes might be useful for preventing bile leakage and subsequent organ/space SSI after procedures that extensively expose Glissonean pedicles.