Risk factors for infectious complications after hepatectomy in patients with intrahepatic bile duct stones / 临床肝胆病杂志

ABSTRACT

Objective To investigate the risk factors for infectious complications after hepatectomy in patients with intrahepatic bile duct stones.Methods A retrospective analysis was performed for the clinical data of 168 patients with intrahepatic bile duct stones who underwent hepatectomy in The Fifth People's Hospital of Ji'nan from January 2010 to December 2016.A univariate analysis was performed for potential risk factors for infectious complications after hepatectomy,and the chi-square test was used for comparison of categorical data between groups.A multivariate logistic regression analysis was performed for the factors with statistical significance.Results Of all patients,31 (18.5％) experienced infectious complications after surgery.No patient underwent reoperation and all patients were cured.The univariate analysis showed that age,preoperative albumin level,biliary cirrhosis,interval between surgery and acute cholangitis (ISAC),extent of hepatectomy,and choledochoenterostomy were influencing factors for postoperative infectious complications (x2 =5.407,4.263,11.633,6.023,5.000,and 5.815,all P ＜ 0.05).The multivariate analysis showed that biliary cirrhosis (odds ratio [OR] =3.028,95％ confidence interval [CI]1.791-5.121,P =0.002),ISAC ＜ 4 weeks (OR =1.539,95 ％ CI1.010-2.345,P =0.046),and choledochoenterostomy (OR =2.389,95 ％ CI1.261-4.527,P =0.028) were independent risk factors for infectious complications after hepatectomy in patients with intrahepatic bile duct stones.Conclusion Patients with intrahepatic bile duct stones,particularly those with biliary cirrhosis,ISAC ＜ 4 weeks,and choledochoenterostomy,have a high risk of developing infectious complications after hepatectomy.Control and improvement of these factors may help with the early prevention of postoperative infectious complications.