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Additional surgical procedure is a risk factor for surgical site infections after laparoscopic cholecystectomy

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Abstract

Purpose

Surgical site infections (SSI) are associated with increased costs and length of hospital stay, readmission rates, and mortality. The aim of this study was to identify risk factors for SSI in patients undergoing laparoscopic cholecystectomy.

Methods

Analysis of 35,432 laparoscopic cholecystectomies of a prospective multicenter database was performed. Risk factors for SSI were identified among demographic data, preoperative patients’ history, and operative data using multivariate analysis.

Results

SSIs after laparoscopic cholecystectomy were seen in 0.8 % (n = 291) of the patients. Multivariate analysis identified the following parameters as risk factors for SSI: additional surgical procedure (odds ratio [OR] 4.0, 95 % confidence interval [CI] 2.2–7.5), age over 55 years (OR 2.4 [1.8–3.2]), conversion to open procedure (OR 2.6 [1.9–3.6]), postoperative hematoma (OR 1.9 [1.2–3.1]), duration of operation >60 min (OR 2.5 [1.7–3.6], cystic stump insufficiency (OR 12.5 [4.2–37.2]), gallbladder perforation (OR 6.2 [2.4–16.1]), gallbladder empyema (OR 1.7 [1.1–2.7]), and surgical revision (OR 15.7 [10.4–23.7]. SSIs were associated with a significantly prolonged hospital stay (p < 0.001), higher postoperative mortality (p < 0.001), and increased rate of surgical revision (p < 0.001).

Conclusions

Additional surgical procedure was identified as a strong risk factor for SSI after laparoscopic cholecystectomy. Furthermore, operation time >60 min, age >55 years, conversion to open procedure, cystic stump insufficiency, postoperative hematoma, gallbladder perforation, gallbladder empyema, or surgical revision were identified as specific risk factors for SSI after laparoscopic cholecystectomy.

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Conflicts of interest

All authors have no conflicts of interest or financial ties to disclose.

Authors’ contributions:

Study conception and design

R. Fahrner, T. Malinka, J. Klasen, D. Candinas, G. Beldi

Acquisition of data

R. Fahrner, T. Malinka, J. Klasen

Analysis and interpretation of data

R. Fahrner, T. Malinka, J. Klasen, D. Candinas, G. Beldi

Drafting of manuscript

R. Fahrner

Critical revision of manuscript

T. Malinka, J. Klasen, D. Candinas, G. Beldi

Author information

Authors and Affiliations

  1. Division of Visceral Surgery and Medicine, University Hospital Bern, 3010, Bern, Switzerland

    René Fahrner, Thomas Malinka, Jennifer Klasen, Daniel Candinas & Guido Beldi

Authors
  1. René Fahrner
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  2. Thomas Malinka
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  3. Jennifer Klasen
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  4. Daniel Candinas
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  5. Guido Beldi
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Corresponding author

Correspondence to Guido Beldi.

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Fahrner, R., Malinka, T., Klasen, J. et al. Additional surgical procedure is a risk factor for surgical site infections after laparoscopic cholecystectomy. Langenbecks Arch Surg 399, 595–599 (2014). https://doi.org/10.1007/s00423-014-1197-3

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  • DOI: https://doi.org/10.1007/s00423-014-1197-3

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