Risk factors for surgical site infection in patients after open biliary surgery excluding cholecystectomy

doi:10.3877/cma.j.issn.2095-3232.2018.01.011

Abstract

Abstract:

Objective

To explore the risk factors for surgical site infection (SSI) in patients after open biliary surgery excluding cholecystectomy.

Methods

Clinical data of 241 patients who underwent open biliary surgery excluding cholecystectomy in Eastern Hepatobiliary Surgery Hospital between April and May 2015 were analyzed retrospectively. The informed consents of all patients were obtained and the local ethical committee approval was received. There were 109 males and 132 females, aged from 24 to 77 and with a median age of 58 years old. General data of the patients were collected and SSI was observed. Related risk factors for SSI of the patients were analyzed using logistic regression, and the preventive treatments were summarized.

Results

The incidence of postoperative SSI was 8.3% (20/241). All SSI occurred on postoperative 1-14 d, with a median of 4 d. There were 10 cases whose SSI occurred at the abdomen, 8 cases at the biliary tract and 2 at the incision. Among the 20 cases with SSI, 15 cases suffered from bacterial infection, 1 case suffered from fungal infection and no bacteria was cultured in 4 cases. Multi-factor logistic regression analysis results showed that choledochojejunostomy, preoperative WBC >10×10⁹/L and drainage tube indwelling time >8 d were the independent risk factors for SSI of these patients (OR=0.332, 0.177, 0.235; P<0.05).

Conclusions

SSI of patients with open biliary surgery excluding cholecystectomy is closely related to choledochojejunostomy, bile duct inflammation and postoperative drainage. It is of great significance to effectively control bile duct inflammation and ensure postoperative unobstructed drainage in preventing SSI after biliary surgery.

Key words: Biliary tract surgical procedures, Surgical site infection, Risk factors

Wenchang Cai, Lei Zhang, Yijun Zhao, Weifeng Shen, Jiamei Yang. Risk factors for surgical site infection in patients after open biliary surgery excluding cholecystectomy[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2018, 07(01): 40-43.

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References 21

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临床参数	例数	数值	单因素分析		多因素分析
临床参数	例数	数值	OR（95%CI）	P值	OR（95%CI）	P值
年龄（岁，±s）	241	57±12	1.001(0.963～1.041)	0.962	-	-
术中出血量	241	200(10～2 000)	1.001(1.000～1.002)	0.150	-	-
手术时间（min，±s）	241	176±72	1.004(0.998～1.010)	0.240	-	-
术前Hb（g/L，±s）	241	129±16	0.992(0.965～1.019)	0.549	-	-
术前ALB（g/L，±s）	241	41±4	0.940(0.844～1.047)	0.259	-	-
术中输血量	241	0(0～6 500)	1.001(1.000～1.001)	0.005	1.000(0.999～1.000)	0.065
性别男	109	-	1.010(0.403～2.534)	0.983	-	-
有吸烟史	49	-	1.023(0.326～3.209)	0.969	-	-
有糖尿病史	24	-	2.207(0.282～17.260)	0.451	-	-
二次手术史	63	-	0.630(0.240～1.659)	0.350	-	-
未合理加用抗生素^a	80	-	0.464(0.185～1.165)	0.102	-	-
胆管结石	121	-	1.569(0.618～3.998)	0.344	-	-
使用二代头孢类抗生素^b	219	-	0.501(0.064～3.930)	0.511	-	-
胆肠吻合术	71	-	0.305(0.120～0.772)	0.012	0.332(0.115～0.960)	0.042
术前WBC>10×10⁹/L	13	-	0.170(0.047～0.612)	0.019	0.177(0.042～0.749)	0.030
术前TB>34 μmol/L	58	-	0.348(0.137～0.888)	0.027	0.758(0.253～2.274)	0.622
术后并发症^c	28	-	0.348(0.116～1.047)	0.060	-	-
引流管留置时间>8 d	36	-	0.133(0.051～0.351)	<0.001	0.235(0.081～0.680)	0.008

临床参数	例数	数值	单因素分析		多因素分析
临床参数	例数	数值	OR（95%CI）	P值	OR（95%CI）	P值
年龄（岁，±s）	241	57±12	1.001(0.963～1.041)	0.962	-	-
术中出血量	241	200(10～2 000)	1.001(1.000～1.002)	0.150	-	-
手术时间（min，±s）	241	176±72	1.004(0.998～1.010)	0.240	-	-
术前Hb（g/L，±s）	241	129±16	0.992(0.965～1.019)	0.549	-	-
术前ALB（g/L，±s）	241	41±4	0.940(0.844～1.047)	0.259	-	-
术中输血量	241	0(0～6 500)	1.001(1.000～1.001)	0.005	1.000(0.999～1.000)	0.065
性别男	109	-	1.010(0.403～2.534)	0.983	-	-
有吸烟史	49	-	1.023(0.326～3.209)	0.969	-	-
有糖尿病史	24	-	2.207(0.282～17.260)	0.451	-	-
二次手术史	63	-	0.630(0.240～1.659)	0.350	-	-
未合理加用抗生素^a	80	-	0.464(0.185～1.165)	0.102	-	-
胆管结石	121	-	1.569(0.618～3.998)	0.344	-	-
使用二代头孢类抗生素^b	219	-	0.501(0.064～3.930)	0.511	-	-
胆肠吻合术	71	-	0.305(0.120～0.772)	0.012	0.332(0.115～0.960)	0.042
术前WBC>10×10⁹/L	13	-	0.170(0.047～0.612)	0.019	0.177(0.042～0.749)	0.030
术前TB>34 μmol/L	58	-	0.348(0.137～0.888)	0.027	0.758(0.253～2.274)	0.622
术后并发症^c	28	-	0.348(0.116～1.047)	0.060	-	-
引流管留置时间>8 d	36	-	0.133(0.051～0.351)	<0.001	0.235(0.081～0.680)	0.008

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