Objective: Surgical site infection (SSI) is a well-known potential complication following pancreaticoduodenectomy (PD). SSI leads to increased medical costs and a longer hospital stay. Several risk factors for developing SSI have been reported. In the present study, we analyzed preoperative and intraoperative predictive markers for SSI after PD.
Materials and Methods: One hundred consecutive patients who underwent PD in our department from January 2006 to December 2018 were retrospectively analyzed. The patients’ preoperative age, body mass index (BMI), history of smoking, alcohol use, and American Society of Anesthesiologists physical status classification were recorded. The Glasgow prognostic score, prognostic nutritional index, and geriatric nutritional risk index were calculated from routine preoperative blood samples. We also evaluated the operation time, blood loss, and blood transfusion as intraoperative markers. All patients were followed up for the occurrence of postoperative complications, including SSI.
Results: SSI was detected in 47 of 100 patients (47%), and 3 patients died of SSI after PD. Thus, the SSI-related operative mortality rate was 3%. According to the univariate risk analysis and multivariable logistic regression analysis, we found that only intraoperative blood transfusion was a risk factor for occurrence of SSI after PD (a high BMI was a risk factor only in the multivariate analysis).
Conclusions: We must pay special attention to the occurrence of SSI after PD for patients who undergo an intraoperative blood transfusion and the correlation between intraoperative blood transfusion and low postoperative immunity should be analyzed.
Blood transfusion; Immunosuppression; Pancreaticoduodenectomy; Surgical site infection