Postoperative infectious complications after pancreatic resection

Area of Science:

• Gastroenterology and Hepatology
• Surgical Oncology
• Infectious Diseases

Background:

• Pancreatic surgery, while improving in mortality, still presents high morbidity rates.
• Infectious complications remain a significant concern following pancreaticoduodenectomy (PD) and distal pancreatectomy (DP).

Purpose of the Study:

• To determine the prevalence of infectious complications after pancreatic surgery.
• To identify specific risk factors associated with these complications.

Main Methods:

• A multi-institutional analysis of patients undergoing PD or DP between 2010-2012 was conducted.
• Risk factors were identified using univariable and multivariable logistic regression.
• A nomogram was developed to predict the risk of infectious complications.

Main Results:

• Infectious complications occurred in 35.2% of PD patients and 25.2% of DP patients.
• Key risk factors for PD included male sex, older age, obesity, prior malignancy, liver disease, bile contamination, prolonged surgery, blood transfusion, and soft pancreas.
• Key risk factors for DP included steroid use, smoking, prolonged surgery, blood transfusion, and non-laparoscopic approach.
• Postoperative infectious complications significantly increased mortality and reoperation rates for both PD and DP.

Conclusions:

• Prolonged operating time, intraoperative blood transfusion, bile contamination (PD), and non-laparoscopic surgery (DP) are modifiable risk factors.
• Targeting these factors can potentially improve outcomes after pancreatectomy.