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

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

In: Langenbeck's Archives of Surgery, 2014, vol. 399, no. 5, p. 595-599

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    Title
    • Additional surgical procedure is a risk factor for surgical site infections after laparoscopic cholecystectomy
    Author
    • Fahrner, René. Division of Visceral Surgery and Medicine, University Hospital Bern, 3010, Bern, Switzerland
    • Malinka, Thomas. Division of Visceral Surgery and Medicine, University Hospital Bern, 3010, Bern, Switzerland
    • Klasen, Jennifer. Division of Visceral Surgery and Medicine, University Hospital Bern, 3010, Bern, Switzerland
    • Candinas, Daniel. Division of Visceral Surgery and Medicine, University Hospital Bern, 3010, Bern, Switzerland
    • Beldi, Guido. Division of Visceral Surgery and Medicine, University Hospital Bern, 3010, Bern, Switzerland
    Document Type
    • Postprint
    Language
    • English
    Published in
    • Langenbeck's Archives of Surgery, 2014, vol. 399, no. 5, p. 595-599. Springer Berlin Heidelberg
    Other Version
    OAI-PMH Identifier
    • oai:doc.rero.ch:325075
    Summary
    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 55years (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 >60min (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 >60min, age >55years, 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.