World Journal of Surgery

, Volume 39, Issue 5, pp 1185–1192 | Cite as

Risk Factors for Incisional and Organ Space Surgical Site Infections After Liver Resection are Different

  • Takashi Kokudo
  • Emilie Uldry
  • Nicolas Demartines
  • Nermin Halkic
Original Scientific Report



Surgical site infection (SSI) is a common cause of major morbidity after liver resection. This study aimed to identify the risk factors for incisional and organ/space SSIs after liver resection.


Our liver surgery database was retrospectively analyzed for patients treated between January 2009 and November 2012 in a tertiary care Swiss hospital. Univariate and multivariate analyses were conducted on preoperative, intraoperative, and postoperative variables to identify risk factors for incisional and organ/space SSIs.


In a total of 226 patients, SSI incidences were 12.8 % (incisional), 4.0 % (organ/space), and 1.8 % (both). Univariate analysis showed that incisional SSIs were associated with high American Society of Anesthesiologists (ASA) scores, preoperative anemia, hypoalbuminemia, low prothrombin time, viral or alcoholic chronic hepatitis, liver cirrhosis, and prolonged operation times. Organ/space SSIs were associated with high rates of red blood cell transfusions, concomitant bowel surgery, and prolonged operation times. Multivariate analysis revealed that risk factors for incisional SSIs were anemia [odds ratio (OR) 2.82], high ASA scores (OR 2.88), presence of hepatitis or cirrhosis (OR 5.07), and prolonged operation times (OR 9.61). The only risk factor for organ/space SSIs was concomitant bowel surgery (OR 5.53). Hospital stays were similar in organ/space and incisional SSI groups, but significantly longer for those with both organ/space and incisional SSIs.


High ASA scores, anemia, chronic hepatitis or liver cirrhosis, and prolonged operations increased the risk of incisional SSIs; concomitant bowel surgery increased the risk of organ/space SSI. Specific precautions to prevent organ/space and incisional SSIs may shorten hospital stays.


Liver Resection Bile Leakage Colorectal Resection Laparoscopic Liver Resection Underlying Liver Disease 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Conflict of interest

No financial disclosure or competing interests.


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Copyright information

© Société Internationale de Chirurgie 2014

Authors and Affiliations

  • Takashi Kokudo
    • 1
  • Emilie Uldry
    • 1
  • Nicolas Demartines
    • 1
  • Nermin Halkic
    • 1
  1. 1.Department of Visceral SurgeryUniversity Hospital CHUVLausanneSwitzerland

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