title: Risk factors for surgical site infection after hepatectomy for hepatocellular carcinoma.
abstract: OBJECTIVE
  Clarification of risk factors for surgical site infection (SSI) after hepatectomy for hepatocellular carcinoma (HCC) is important for improvement of surgical outcome.
  
  
  METHODS
  The incidences of SSI under various states were evaluated in 171 patients who underwent hepatectomy for HCC. Univariate and logistic regression analysis were performed to identify risk factors for SSI. The relation between postoperative hepatic failure and SSI was also evaluated. Data were analyzed using Stat View 5.0.
  
  
  RESULTS
  SSI occurred in 36 patients (21%). Of the 36 patients with SSI, organ/space SSI occurred in 27. Bile leakage occurred in 22 patients, of which 18 patients had accompanying organ/space SSI. Postoperative hepatic failure occurred in 6 patients, and 5 of these 6 patients also had organ/ space SSI. The postoperative mortality rate was significantly higher in the patients with organ/space SSI (3 of 27 patients, 11%) than in those without organ/space SSI (1 of 144 patients, 0.7%). Logistic regression analysis revealed bile leakage and blood loss to be independent right factors for occurrence of organ/space SSI.
  
  
  CONCLUSIONS
  Bile leakage frequently causes organ/space SSI after hepatectomy. Organ/space SSI is closely related to postoperative hepatic failure and death. Prevention of bile leakage is important to improve the surgical outcome of hepatectomy for HCC.
authors.affiliation: Department of Surgery, Division of Gastroenterological Surgery, Aichi Medical University School of Medicine, Aichi Medical University, Nagakute, Aichi, 480-1195, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Arikawa
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Kurokawa
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Ohwa
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Ito
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Kotake
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nagata
authors.forename: Masahiko
authors.initials: M
authors.lastname: Miyachi
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Suzumura
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Nonami
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D015994:Incidence; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000401:mortality