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Risk Factor of Surgical Site Infection After Pancreaticoduodenectomy

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Abstract

Background

Although surgical site infection (SSI) following pancreaticoduodenectomy is a common complication, the risk factors remain unclear.

Patients and methods

A retrospective study of 408 consecutive patients undergoing pancreaticoduodenectomy was conducted and the risk factors for SSI were assessed. The bacterial composition was also analyzed.

Results

Sixty-one patients developed incisional SSI, and 195 developed organ/space SSI. A multivariate analysis identified that length of operation >480 min (odds ratio [OR] 3.22), main pancreatic duct (MPD) ≤3 mm (OR 2.18), and abdominal wall thickness >10 mm (OR 2.16) were significant risk factors for incisional SSI. The development of pancreatic fistula (OR 7.56), use of semi-closed drainage system (OR 3.68), body mass index >23.5 kg/m2 (OR 3.04), MPD ≤3 mm (OR 2.21), and length of operation >480 min (OR 1.78) were significantly associated with organ/space SSI. Bacterial isolation at the SSI foci revealed that gut-derived micro-organisms were the predominant bacterial species.

Conclusions

The presence of pancreatic fistula was the strongest risk factor for organ/space SSI. Efforts to reduce the development of pancreatic fistulas, to decrease length of operation, and to use a closed drainage system would decrease the incidence of SSI following pancreaticoduodenectomy. If SSI that requires antibacterial treatment occurs, then the treatment should target enterobacteria.

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Conflict of interest

The authors declare no financial or any other type of support.

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Authors and Affiliations

  1. Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, 1007, Shimo-Nagakubo, Sunto-Nagaizumi, Shizuoka, 411-8777, Japan

    Teiichi Sugiura, Katsuhiko Uesaka, Hideyuki Kanemoto & Takashi Mizuno

  2. Division of Infectious Disease, Shizuoka Cancer Center, Shizuoka, Japan

    Norio Ohmagari

Authors
  1. Teiichi Sugiura
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  2. Katsuhiko Uesaka
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  3. Norio Ohmagari
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  4. Hideyuki Kanemoto
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  5. Takashi Mizuno
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Correspondence to Teiichi Sugiura.

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Sugiura, T., Uesaka, K., Ohmagari, N. et al. Risk Factor of Surgical Site Infection After Pancreaticoduodenectomy. World J Surg 36, 2888–2894 (2012). https://doi.org/10.1007/s00268-012-1742-6

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  • DOI: https://doi.org/10.1007/s00268-012-1742-6

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