Patient-Related Risk Factors for Postoperative Infection After Cholecystectomy

The impact of patient-related risk factors on the incidence of postoperative infection after cholecystectomy is relatively unknown.

The aim of this study was to explore potential patient-related risk factors for surgical site infection (SSI) and septicaemia following cholecystectomy.

All cholecystectomies registered in the Swedish national population-based register for Gallstone Surgery and Endoscopic Retrograde Cholangiopancreatography (GallRiks) 2006-2014 were identified. The study cohort was cross-matched with the Swedish National Patient Register in order to obtain data on patient history and postoperative infections. Simple and multiple logistic regression analyses were performed in order to assess the impact of various comorbidities on the risk for SSI and septicaemia.

A total of 94,557 procedures were registered. A SSI was seen following 5300 procedures (5.6%), and septicaemia following 661 procedures (0.7%). There was a significantly increased risk for SSI in patients with connective tissue disease (odds ratio [OR] 1.404, 95% confidence interval [CI] 1.208-1.633), complicated diabetes (OR 1.435, CI 1.205-1.708), uncomplicated diabetes (OR 1.391, CI 1.264-1.530), chronic kidney disease (OR 1.788, CI 1.458-2.192), cirrhosis (OR 1.764, CI 1.268-2.454) and obesity (OR 1.630, CI 1.475-1.802). There was a significantly higher risk for septicaemia in patients with chronic kidney disease (OR 3.065, CI 2.120-4.430) or cirrhosis (OR 5.016, CI 3.019-8.336).

Certain comorbidities have an impact on the risk for postoperative infection after cholecystectomy, especially SSI. This should be taken into account when planning the procedure and when deciding on prophylactic antibiotic treatment.