Postoperative Infections in Hepatopancreatobiliary Malignancy: A Tertiary Care Center Experience

Introduction: Wound infection following surgery is not an uncommon entity in any malignancy. Various factors play a role in the development of infection like diabetes, the duration of surgery, intraoperative blood loss, and prior stenting. Obstructive jaundice is a common presentation in hepatopancreatobiliary malignancy, and most of the patients are being stented to relieve jaundice. The role of preoperative stenting and biopsy in these malignancies is a debatable topic. These procedures have a negative impact on the postoperative outcome. Materials and methods: We have retrospectively analyzed the patients who have undergone surgery involving biliary enteric anastomosis from January 2013 to June 2023, and the following results have been formulated after using appropriate statistical tests for the level of significance. Results: One hundred and fifty patients had surgeries performed involving biliary enteric anastomosis, with M:F=14:11 and a mean age of 57.8 years (standard deviation (SD): 9.6). On performing binary regression analysis using various parameters. Preoperative stenting increases the risk of the growth of bacteria in bile by 12 times (OR: 12, 95% CI: 5.25-27.42, p<0.001) and the presence of bacteria in bile increased the risk of wound infection by 16.5 times (OR: 45, 95% CI: 7-38.89, p<0.001). The duration of hospital stay was significantly longer in patients who developed wound infections, thus increasing the cost of treatment and delaying the initiation of adjuvant treatment. Conclusion: Various factors play a role in the development of wound infections following any surgery. From the analysis performed, we found that the duration of surgery and preoperative procedures in the form of stenting increased the risk of growing bacteria in the bile, which later increased the risk of developing a wound infection. Wound infections prolong the hospital stay and delay the initiation of adjuvant treatment. Thus, preoperative stenting should be performed after discussion in a multidisciplinary tumor board meeting.