ABSTRACT
Objective To identify the independent risk factors of surgical site infections (SSIs) for patients with cholelithiasis after biliary tract surgery.Methods 712 patients were enrolled from April 2010 to April 2015 in this study and their clinical data were retrospectively analyzed.There were 106 patients who developed SSIs.The risk factors of SSIs and their three subtypes (superficial incisional SSIs,deep incisional SSIs,and organ/space SSIs) were analyzed.The total hospitalization cost,length of hospitalization and patients who stayed over 30 days in hospital were compared between the group of patients with and without SSIs.Results Univariate analysis showed that SSIs were associated with diabetes,emergency operation,bile duct re-exploration,hepatectomy,positive bile bacteria culture,porta hepatis clamping,Ⅱ-Ⅳ grades of cholelithiasis,ASA Grade 3,BMI ＞ 30,hepatic function Grade B and protein level ＜ 30 g/L on hospital admission (all P ＜ 0.05).The results also indicated that superficial incisional SSIs,deep incisional SSIs and organ/space SSIs were correlated with emergency operation,bile duct re-exploration,hepatectomy,operation time,porta hepatis clamping,smoking,ASA score and protein level on hospital admission (all P ＜ 0.05).The total hospitalization expense,length of hospital stay and the number of patients hospitalized for over 30 days in the SSIs Group were significantly more than the non-SSIs Group (all P ＜ 0.05).Bile duct re-exploration,hepatectomy,positive bile bacteria culture and Ⅱ-Ⅳ grades of cholelithiasis were independent risk factors of SSIs on multivariate unconditional logistical regression analysis (all P ＜ 0.05).Conclusions Multiple factors in the perioperative period were involved in SSIs after bile duct surgery.Bile duct te-exploration,hepatectomy,positive bile bacteria culture and Ⅱ-Ⅳ grades of cholelithiasis were independent risk factors of SSIs.