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World Journal of Surgery

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01-04-2016 | Original Scientific Report

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

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

Published in: World Journal of Surgery | Issue 4/2016

Abstract

Background

The 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.

Methods

We 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.

Results

Twenty-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).

Conclusions

Preexisting 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.

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Title: High Rate of Organ/Space Surgical Site Infection After Hepatectomy with Preexisting Bilioenteric Anastomosis
Authors: Masaru Matsumura
Akio Saiura
Yosuke Inoue
Takeaki Ishizawa
Yoshihiro Mise
Yu Takahashi
Publication date: 01-04-2016
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 4/2016
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-015-3340-x

At a glance: The STEP trials

Springer Medicine

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

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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