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Clinical Predictive Score for Cholecystectomy Wound Infection: WEBAC Score

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Background

Most common surgical complications in cholecystectomy are surgical site infections (SSIs). SSIs have many factors, including patient, surgical, and disease factors. This study aims to find the factors which relate to SSIs 30 days after cholecystectomy and contribute to the scoring system to predict SSIs.

Methods and Material

The data of patients who underwent cholecystectomy from January 2015 to December 2019 were retrospectively collected from a prospectively collected infectious control registry. The SSI was defined following the CDC criteria and assessed before discharge and at a 1-month follow-up. Variables that were independently predictive of the increased SSIs were included in the risk score.

Results

The patients who underwent cholecystectomy were 949, which were divided into 28 patients who had SSIs and 921 who had no SSIs. The rate of SSIs was 3%. The factors related to SSI in cholecystectomy were age ≥ 60 years (p = 0.045), history of smoking (p = 0.004), retrieval bag use (p = 0.005), preoperative ERCP (p = 0.02), and wound class III and IV (p = 0.007). Risk assessment was using five variables (WEBAC): (1) wound classifications, (2) preoperative ERCP, (3) retrieval plastic bag use, (4) aged ≥ 60 years, and (5) history of smoking (cigarette). If patients were aged ≥ 60 years and had a history of smoking, no plastic bag use, preoperative ERCP, or wound class III or IV, these parameters would all be scored 1 each. The WEBAC score revealed the probability of SSIs in cholecystectomy wounds.

Conclusion

The WEBAC score represents a convenient and simple tool to predict the probability of SSI in the patients who underwent cholecystectomy and might increase the surgeons’ awareness of postoperative SSI.

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Abbreviations

IQR :

interquartile range

kg :

kilogram

m :

meter

RLQ :

right lower quadrant

ERCP :

endoscopic retrograde cholangiopancreatography

CI :

confidence interval

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Data Availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

Authors

Contributions

WC, SS, SM, and CS participated in study conception and design, material preparation, and data collection. WC and CS performed data analysis and prepared the first draft of the manuscript. WC, SS, SM, and CS critically reviewed the manuscript. WC revised the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Chutida Sungworawongpana MD.

Ethics declarations

Ethics Approval and Consent to Participate

The Ethics Committee of Research Institute, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand, approved all procedures concerning human participants (REC.63-048-10-1). This study was performed in accordance with the ethical standards of the Declaration of Helsinki (1964) and its later amendments or comparable ethical guidelines. Written informed consent was obtained from all the participants included in the study.

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Not applicable.

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The authors declare no competing interests.

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Chaochankit, W., Samphao, S., Mahattanobon, S. et al. Clinical Predictive Score for Cholecystectomy Wound Infection: WEBAC Score. J Gastrointest Surg 27, 1876–1882 (2023). https://doi.org/10.1007/s11605-023-05750-5

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  • DOI: https://doi.org/10.1007/s11605-023-05750-5

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