Prognostic impact of postoperative infection after resection of biliary malignancy: A multicenter retrospective cohort study

被引：4

作者：

Iseki, Masahiro ^{[1
,23
]}

Mizuma, Masamichi ^{[1
]}

Unno, Michiaki ^{[1
]}

Maruyama, Hiroshi ^{[2
,3
]}

Akagi, Shinji ^{[3
,4
]}

Shimoda, Mitsugi ^{[3
,5
]}

Uemura, Kenichiro ^{[3
,6
]}

Inoue, Toru ^{[3
,7
]}

Shiomi, Hisanori ^{[3
,8
]}

Watanabe, Manabu ^{[3
,9
]}

Kobayashi, Minako ^{[3
,10
]}

Matsuda, Akihisa ^{[3
,11
]}

Mizuuchi, Yusuke ^{[3
,12
]}

Aoki, Taku ^{[3
,13
]}

Shinkawa, Hiroji ^{[3
,14
,17
]}

Takahata, Risa ^{[3
,15
]}

Makino, Kenta ^{[3
,16
]}

Arai, Hiroki ^{[3
]}

Yokoyama, Yasuyuki ^{[3
,18
]}

Takeda, Shigeru ^{[3
,19
]}

Yaguchi, Yoshihisa ^{[3
,20
]}

Kitagawa, Yuko ^{[21
,22
]}

机构：

[1] Tohoku Univ, Grad Sch Med, Dept Surg, Sendai, Japan

[2] Tama Nagayama Hosp, Nippon Med Sch, Dept Surg, Tokyo, Japan

[3] Japan Soc Surg Infect, Clin Res Support Comm, Tokyo, Japan

[4] Mazda Hosp, Dept Surg, Hiroshima, Japan

[5] Tokyo Med Univ, Ibaraki Med Ctr, Dept Gastroenterol Surg, Ibaraki, Japan

[6] Hiroshima Univ, Grad Sch Biomed & Hlth Sci, Dept Surg, Hiroshima, Japan

[7] Osaka City Gen Hosp, Dept Gastrointestinal Surg, Osaka, Japan

[8] Nagahama Red Cross Hosp, Dept Surg, Shiga, Japan

[9] Toho Univ, Ohashi Med Ctr, Dept Surg, Tokyo, Japan

[10] Musashikosugi Hosp, Nippon Med Sch, Dept Infect Control & Prevent, Kawasaki, Kanagawa, Japan

[11] Nippon Med Sch, Dept Gastrointestinal & Hepatobiliary Pancreat Sur, Tokyo, Japan

[12] Kyushu Univ, Grad Sch Med Sci, Dept Surg & Oncol, Fukuoka, Japan

[13] Dokkyo Med Univ, Dept Hepatobiliary Pancreat Surg, Mibu, Japan

[14] Osaka Metropolitan Univ, Grad Sch Med, Dept Hepatobiliary Pancreat Surg, Osaka, Japan

[15] Natl Def Med Coll, Dept Med Risk Management & Infect Control, Saitama, Japan

[16] Kyoto Univ, Grad Sch Med, Dept Surg, Kyoto, Japan

[17] Chiba Hokusoh Hosp, Nippon Med Sch, Dept Surg, Chiba, Japan

[18] Musashikosugi Hosp, Dept Digest Surg, Nippon Med Sch, Kawasaki, Kanagawa, Japan

[19] Yamaguchi Univ, Grad Sch Med, Dept Gastroenterol Breast & Endocrine Surg, Yamaguchi, Japan

[20] Sassa Gen Hosp, Dept Surg, Tokyo, Japan

[21] Keio Univ, Sch Med, Dept Surg, Tokyo, Japan

[22] Japan Soc Surg Infect, Tokyo, Japan

[23] Tohoku Univ, Dept Surg, Grad Sch Med, 1-1 Seryo Machi,Aoba Ku, Sendai, Miyagi 9808574, Japan

来源：

SURGERY | 2023年 / 174卷 / 05期

关键词：

INITIAL DISEASE RECURRENCE; PANCREATIC FISTULA; CURATIVE RESECTION; COMPLICATIONS; SURVIVAL; CANCER; CHOLANGIOCARCINOMA; PATTERNS; PANCREATICODUODENECTOMY; OUTCOMES;

D O I：

10.1016/j.surg.2023.05.019

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Background: The aim of this study was to investigate the prognostic impact of postoperative infections in patients who underwent resection for biliary malignancy, including intrahepatic cholangiocarcinoma, perihilar cholangiocarcinoma, distal cholangiocarcinoma, gallbladder carcinoma, and carcinoma of the ampulla of Vater. Methods: This study was conducted in an 11-center retrospective cohort study. Patients with biliary tract cancer who underwent curative resection between April 2013 and March 2015 at 11 institutions in Japan were enrolled. We analyzed the prevalence of postoperative infection, infection-related factors, and prognostic factors. Results: Of the total 290 cases, 33 were intrahepatic cholangiocarcinoma, 60 were perihilar cholangiocarcinoma, 120 were distal cholangiocarcinoma, 55 were gallbladder carcinoma, and 22 were carcinoma of the ampulla of Vater. Postoperative infectious complications, including remote infection, were observed in 146 patients (50.3%), and Clavien-Dindo >= III in 115 patients (39.7%). Postoperative infections occurred more commonly in the patients who received pancreaticoduodenectomy and bile duct resection. Patients with infectious complications had a significantly poorer prognosis than those without (median overall survival 38 months vs 62 months, P = .046). In a diagnosis-specific analysis, although there was no correlation between infectious complications and overall survival in intrahepatic cholangiocarcinoma, perihilar cholangiocarcinoma, distal cholangiocarcinoma, and carcinoma of the ampulla of Vater, infectious complications were a significantly poor prognostic factor in gallbladder carcinoma (P = .031). Conclusion: Postoperative infection after surgery for biliary tract cancer commonly occurred, especially in patients who underwent pancreaticoduodenectomy and bile duct resection. Postoperative infection is relatively associated with the prognosis of patients with biliary malignancy, especially gallbladder carcinoma. (c) 2023 Published by Elsevier Inc.

引用

页码：1145 / 1152

页数：8

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