The Risk Factors and Measures of Postoperative Infection in Liver Surgery

Kazuhiko Sakamoto, Toshimasa Okada, Takao Tamesa and Masaaki Oka

Department of Digestive Surgery and Surgical Oncology, Yamaguchi University Graduate School of Medicine

Purpose: We studied the postoperative infection after hepatectomy based on the risk factors in the CDC guideline and the results of perioperative culture. Patients and methods: Subjects were 80 patients undergoing hepatectomy from January 2003 through June 2005. We cultured nasal discharge and gastric juice obtained preoperatively and sputum, bile, and ascites obtained one day after surgery. We studied the frequency of postoperative infection and risk factors. Results: Bacteria were detected in 27% of nasal discharge, 59% of gastric juice, 52% of sputum, 19% of bile, and 5% of ascites. Postoperative infection occurred in 15/80 cases (19%), and 11 of 15 bacteria detected from infected site were identical to bacteria detected before and 1 day after surgery. Univariate analysis suggested that significant risk facters for postoperative infection were positive culture in sputum, bile, and ascites (p<0.05). Factors associated by multivariate analysis with postoperative infection included gender, glucose intolerance, liver fibrosis, operation time, and positive culture (p<0.05). Conclusions: Our results suggest that patients with liver cirrhosis may be at high risk for postoperative infection. Perioperative positive culture in sputum, bile, and ascites is the risk factor for postoperative infection, and this information of perioperative culture may be useful in appropriate selection of antibacterial agents against postoperative infection.

Key words
liver surgery, postoperative infection, bacteria carrier

Reprint requests
Kazuhiko Sakamoto Department of Digestive Surgery and Surgical Oncology, Yamaguchi University Graduate School of Medicine
1-1-1 Minamikogushi, Ube, 755-8505 JAPAN

Accepted
October 25, 2006

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