Preoperative Risk Factor Analysis and Prognosis of Sepsis After Elective Hepatobiliary and Pancreatic Surgery

DOI
  • Katayose Yu
    Hepatobiliary and Pancreatic Surgery, Tohoku Medical and Pharmaceutical University
  • Ise Ichiro
    Department of Surgery, Tohoku University Graduate School of Medicine
  • Hayashi Hiroki
    Department of Surgery, Tohoku University Graduate School of Medicine
  • Nakagawa Kei
    Department of Surgery, Tohoku University Graduate School of Medicine
  • Morikawa Takanori
    Department of Surgery, Tohoku University Graduate School of Medicine
  • Mizuma Masamichi
    Department of Surgery, Tohoku University Graduate School of Medicine
  • Ohtsuka Hideo
    Department of Surgery, Tohoku University Graduate School of Medicine
  • Mutoh Mitsuhisa
    Department of Surgery, Tohoku Rosai Hospital
  • Tokumura Hiromi
    Department of Surgery, Tohoku Rosai Hospital
  • Motoi Fuyuhiko
    Department of Surgery, Tohoku University Graduate School of Medicine
  • Naitoh Takeshi
    Department of Surgery, Tohoku University Graduate School of Medicine
  • Unno Michiaki
    Department of Surgery, Tohoku University Graduate School of Medicine

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Other Title
  • 待機的肝胆膵術後敗血症の術前リスク因子解析および予後の検討

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Abstract

<p>PURPOSE: We aimed to analyze the risk factor of sepsis after hepatobiliary and pancreatic surgery and to investigate the prognosis. METHODS:The subjects were retrospectively studied from the database for hepatobiliary and pancreatic surgery cases, who had undergone a surgical operation at Tohoku University Hospital and Tohoku Rosai Hospital from 2011 to 2015. RESULTS:A total of 523 cases were reviewed. The sepsis rates were 6%, 16%, 10%, 33% and 56% in pancreaticoduodenectomy (PD), hepatectomy, total pancreatectomy, distal pancreatectomy combined with celiac axis resection, and hepato-pancreaticoduodenectomy, respectively. In the PD group, it was found that the low value of hemoglobin was a risk factor, and in the hepatectomy group, a prolonged activated partial thromboplastin time (APTT) was a risk factor. Regarding the long-term prognosis, when the overall survival rate was examined except for 90-day mortality with sepsis cases and benign diseases, sepsis cases showed a poor prognosis in the hepatectomy group. CONCLUSIONS: Because sepsis might have a relationship with the long-term prognosis, highly invasive surgery for hepatobiliary and pancreatic surgery requires postoperative management based on the preoperative risk factors with sepsis in mind.</p>

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