Abstract
Background
Few reports have addressed postoperative infectious complications caused by multidrug-resistant
pathogens. The aim of this study was to review the surgical outcomes of patients undergoing
major hepatectomy with extrahepatic bile duct resection and to clarify the incidence
of and the risk factors for postoperative infectious complications caused by multidrug-resistant
pathogens.
Methods
Medical records of consecutive patients who underwent major hepatectomy with extrahepatic
bile duct resection between 2006 and 2017 were retrospectively reviewed.
Results
Among 620 study patients, 219 had postoperative infectious complications, including
62 (10.0%) with postoperative infectious complications caused by multidrug-resistant
pathogens. The mortality of the 62 patients with postoperative infectious complications
caused by multidrug-resistant pathogens was higher (n = 8, 12.9%) than that in the 157 patients with postoperative infectious complications
caused by non-multidrug-resistant pathogens(n = 2, 1.3%) (P < .001). With multivariate analysis, the presence of preoperative cholangitis, the
extent of liver resection more than 50%, operative time longer than 600 minutes, the
amount of blood loss more than 1500 mL, and the presence of postoperative infectious
complications caused by multidrug-resistant pathogens were identified as independent
risk factors for postoperative death. The presence of multidrug-resistant pathogens
in preoperative bile culture, the amount of blood loss greater than 1500 mL, the presence
of bile leakage, and pancreatic fistula were identified as independent risk factors
for postoperative infectious complications caused by multidrug-resistant pathogens.
Conclusion
The incidence of postoperative infectious complications caused by multidrug-resistant
pathogens in patients undergoing major hepatectomy with extrahepatic bile duct resection
is high, approximately 10%. This troublesome complication is closely associated with
postoperative death. Thus, preventing postoperative infectious complications caused
by multidrug-resistant pathogens is an urgent task to improve surgical outcome after
major hepatectomy with extrahepatic bile duct resection.
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Article info
Publication history
Published online: April 14, 2020
Accepted:
February 16,
2020
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
