Risk factors and long-term outcome for postoperative intra-abdominal infection after hepatectomy for hepatocellular carcinoma

Intra-abdominal infection (IAI) after hepatectomy is an important morbidity. Identification of risk factors that could be avoided in the perioperative period may reduce the prevalence of IAI after hepatectomy for hepatocelluar carcinoma (HCC). Between January 1995 and December 2009, all patients with HCC who underwent curative liver resection were evaluated retrospectively. Long-term outcomes were compared in IAI patients and non-IAI patients after hepatectomy. Preoperative, intraoperative, and tumor-related factors that could be independent factors for postoperative IAI were identified. Of 622 patients with HCC, 24 patients (3.9%) had IAI after hepatectomy. Both median survival and survival of patients with postoperative IAI were shorter than those for non-IAI patients (P < .05). Upon univariate analysis followed by multivariate analyses, three independent predictors for IAI were identified: weight loss (odds ratio [OR], 3.27; 95% confidence interval [CI], 1.17–9.11; P = .024), liver cirrhosis (0.28, 0.12–0.67, .004), and operative time >300 minutes (3.44, 1.46–8.12, .005). IAI after hepatectomy affects outcome adversely. Preoperative weight loss, liver cirrhosis, and operative time >300 minutes are independent predictors of postoperative IAI.