TY - JOUR
T1 - Liver resections in patients with prior bilioenteric anastomosis are predisposed to develop organ/space surgical site infections and biliary leakage
T2 - results from a propensity score matching analysis
AU - Morikawa, Takanori
AU - Ishida, Masaharu
AU - Iseki, Masahiro
AU - Aoki, Shuichi
AU - Hata, Tatsuo
AU - Kawaguchi, Kei
AU - Ohtsuka, Hideo
AU - Mizuma, Masamichi
AU - Hayashi, Hiroki
AU - Nakagawa, Kei
AU - Kamei, Takashi
AU - Unno, Michiaki
N1 - Publisher Copyright:
© 2020, Springer Nature Singapore Pte Ltd.
PY - 2021/4
Y1 - 2021/4
N2 - Purpose: The aims of this study were to compare the perioperative outcomes after hepatectomy with prior bilioenteric anastomosis to those without prior anastomosis, and to elucidate the mechanisms and preventative measures of its characteristic complications. Methods: The demographic data and perioperative outcomes of 525 hepatectomies performed between January 2007 and December 2018, including 40 hepatectomies with prior bilioenteric anastomosis, were retrospectively analyzed. Results: A propensity score matching analysis demonstrated that hepatectomies with prior bilioenteric anastomosis were associated with a higher frequency of major complications (p = 0.015), surgical site infection (p = 0.005), organ/space surgical site infection (p = 0.003), and bile leakage (p = 0.007) compared to those without. A multivariate analysis also elucidated that prior bilioenteric anastomosis was one of the independent risk factors of organ/space surgical site infection. In the patients with prior bilioenteric anastomosis, bile leakage was associated with organ/space surgical site infection at a significantly higher rate than those without prior bilioenteric anastomosis (p < 0.001). Conclusions: Prior bilioenteric anastomosis is a strong risk factor for organ/space surgical site infections, which might be induced by bile leakage. To prevent infectious complications after hepatectomy with prior bilioenteric anastomosis, meticulous liver transection to reduce bile leakage rate is thus considered to be mandatory.
AB - Purpose: The aims of this study were to compare the perioperative outcomes after hepatectomy with prior bilioenteric anastomosis to those without prior anastomosis, and to elucidate the mechanisms and preventative measures of its characteristic complications. Methods: The demographic data and perioperative outcomes of 525 hepatectomies performed between January 2007 and December 2018, including 40 hepatectomies with prior bilioenteric anastomosis, were retrospectively analyzed. Results: A propensity score matching analysis demonstrated that hepatectomies with prior bilioenteric anastomosis were associated with a higher frequency of major complications (p = 0.015), surgical site infection (p = 0.005), organ/space surgical site infection (p = 0.003), and bile leakage (p = 0.007) compared to those without. A multivariate analysis also elucidated that prior bilioenteric anastomosis was one of the independent risk factors of organ/space surgical site infection. In the patients with prior bilioenteric anastomosis, bile leakage was associated with organ/space surgical site infection at a significantly higher rate than those without prior bilioenteric anastomosis (p < 0.001). Conclusions: Prior bilioenteric anastomosis is a strong risk factor for organ/space surgical site infections, which might be induced by bile leakage. To prevent infectious complications after hepatectomy with prior bilioenteric anastomosis, meticulous liver transection to reduce bile leakage rate is thus considered to be mandatory.
KW - Bile leakage
KW - Hepatectomy
KW - Liver resection
KW - Prior bilioenteric anastomosis
KW - Surgical site infection
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U2 - 10.1007/s00595-020-02105-4
DO - 10.1007/s00595-020-02105-4
M3 - Article
C2 - 32785844
AN - SCOPUS:85089312605
VL - 51
SP - 526
EP - 536
JO - Surgery Today
JF - Surgery Today
SN - 0941-1291
IS - 4
ER -