Etiological factors for subphrenic infection after hepatectomy for patients with hepatic malignancy.
BACKGROUND
This study was to clarify the high risk factors for subphrenic infection (SI) after liver resection for patients with hepatic malignancy.


METHODS
Three hundred and sixty-eight patients who had undergone hepatectomy from January 1985 through June 2002 were randomly divided into 2 groups according to resection of liver parenchyma, hepatic cirrhosis, primary liver cancer, intraoperative blood loss, and subphrenic drainage. The chi-square was used for statistical analysis.


RESULTS
Thirteen patients (3.53%) of the 368 patients had SI. The high-risk factors for SI after hepatectomy were related to resection of liver parenchyma and hepatic cirrhosis; but the course or stage of primary liver cancer was not related to the incidence of SI. Intraoperative blood loss of over 1500 ml was found to be a significant risk factor for postoperative SI. Adequate drainage of the subdiaphragm and the raw surface of the liver after operation was essential to decreasing SI after liver resection.


CONCLUSIONS
Inadequate subphrenic drainage may largely contribute to SI in patients with hepatic malignancy undergoing hepatectomy apart from other factors. Comprehensive measures should be taken to prevent the infection after hepatectomy.
Xing
Xue
X
Department of Hepatobiliary Surgery, Qingdao Municipal Hospital, Qingdao 266011, China. xingxue@gdcnc.com
Li
Hong
H
Liu
Wei-Guo
WG
Xia
Sui-Sheng
SS
Chen
Xiao-Ping
XP
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D004322:Drainage; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008103:Liver Cirrhosis / Q000453:epidemiology; D008113:Liver Neoplasms / Q000453:epidemiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010529:Peritoneal Cavity; D010538:Peritonitis / Q000453:epidemiology / Q000209:etiology*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D013369:Subphrenic Abscess / Q000453:epidemiology / Q000209:etiology*