Risk factors of local infection after cholecystectomy and criteria of smooth postoperative period

Timerbulatov M.V.; Grushevskaya E.A.; Grishina E.E.

doi:https://doi.org/10.17116/hirurgia202008123

Timerbulatov M.V.

Bashkir State Medical University

Grushevskaya E.A.

Bashkir State Medical University

Grishina E.E.

Bashkir State Medical University

Risk factors of local infection after cholecystectomy and criteria of smooth postoperative period

Authors:

Timerbulatov M.V., Grushevskaya E.A., Grishina E.E.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2020;(8): 23‑28

DOI: 10.17116/hirurgia202008123

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To cite this article:

Timerbulatov MV, Grushevskaya EA, Grishina EE. Risk factors of local infection after cholecystectomy and criteria of smooth postoperative period. Pirogov Russian Journal of Surgery. 2020;(8):23‑28. (In Russ.)
https://doi.org/10.17116/hirurgia202008123

Подписка 2026 Хирургия. Журнал им. Н.И. Пирогова (Pirogov Russian Journal of Surgery)

Использование инфографики авторами научных работ

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OBJECTIVE

To identify the criteria of smooth postoperative period after cholecystectomy and risk factors of local surgical infection.

MATERIAL AND METHODS

A prospective analysis included 680 patients after laparoscopic cholecystectomy. We assessed incidence and risk factors of infectious complications. Major markers of acute inflammation, ultrasonic features of surgical site in early postoperative period were analyzed.

RESULTS

Postoperative infectious complications developed in 35 patients (5.1%). All studied risk factors except an age (obesity, cardiorespiratory diseases, surgery time over 150 min, violation of the principles of antibiotic therapy, intraoperative blood loss over 50 ml, drainage time over 5 days) significantly affected the development of infectious complications. Surgery time over 150 min and violation of the principles of antibiotic therapy were the most significant factors. Serum procalcitonin, erythrocyte sedimentation rate and C-reactive protein were characterized by the highest prognostic value on the 3^rd postoperative day. Threshold values were defined.

CONCLUSION

Surgery time and violation of the rules of antibiotic prophylaxis were the most significant risk factors of postoperative infectious complications. We determined the criteria of smooth postoperative period: procalcitonin <1.5 mg/l, C-reactive protein <50 mg/l, erythrocyte sedimentation rate <39 mm/h, ultrasonic pattern of hypoechoic accumulation within the bed of the bladder (dimension <10 mm) without signs of intestinal insufficiency, abdominal or subhepatic effusion on the 3^rd day after surgery.

Keywords:

infection of surgical area

complications after cholecystectomy

risk factors

markers of inflammation

Authors:

Timerbulatov M.V.

Bashkir State Medical University

Grushevskaya E.A.

Bashkir State Medical University

Grishina E.E.

Bashkir State Medical University

Received:

03.09.2019

Accepted:

11.11.2019

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References:

Lim C, Bou Nassif G, Lahat E. Single-incision robotic cholecystectomy is associated with a high rate of trocar-site infection. Int J Med Robot. 2017;13(4).
Sutijono D, DeClerck M. Point-of-Care Ultrasound Diagnosis of A Post-Cholecystectomy Abscess. The Journal of Emergency Medicine. 2013;44(5):359-360.
Chong V, Ram R. Laparoscopic drainage of abdominal wall abscess from spilled stones post-cholecystectomy. J Surg Case Rep. 2015;2015(7).
Mueck KM, Kao LS. Patients at High-Risk for Surgical Site Infection. Surgical Infections. 2017;18(4):440-446.
Ejaz A, Schmidt C, Johnston FM, Frank SM, Pawlik TM. Risk factors and prediction model for inpatient surgical site infection after major abdominal surgery. J Surg Res. 2017;217:153-159.
Program SCAT (Control Strategy Of Antimicrobial Therapy) in the provision of medical care in hospital. Pod red. Yakovleva S.V., Brico N.I., Sidorenco S.V. M.: Publishing house: «Pero»; 2018. (In Russ.).
Altirev BK, Rachimov OY, Tursumetov AA. Features of clinical manifestations of intraperitoneal complications after operations on the biliary tract. Young scientist. 2016;27(131):230-234 (In Russ.).
Waltz PK, Zuckerbraun BS. urgical Site Infections and Associated Operative Characteristics. Surgical Infections. 2017;18(4):447-450.
Mueck KM, Kao LS. Patients at High-Risk for Surgical Site Infection. Surg Infect (Larchmt). 2017;18(4):440-446.
Laiman EF, Sharkova VA, Shevelev IK. Risk factors for surgical site infection. Bacteriology. 2017;2:3:75. (In Russ.).
Gouvêa M, Novaes Cde O, Pereira DM, Iglesias AC. Adherence. to guidelines for surgical antibiotic prophylaxis: a review. Braz J Infect Dis. 2015;19(5):517-524.
Tonolini M, Ierardi AM, Patella F, Carrafiello G. Early cross-sectional imaging following open and laparoscopic cholecystectomy: a primer for radiologists. Insights Imaging. 2018;9(6):925-941.
Juvany M, Guirao X, Oliva JC, Badía Pérez JM. Role of Combined Post-Operative Venous Lactate and 48 Hours C-Reactive Protein Values on the Etiology and Predictive Capacity of Organ-Space Surgical Site Infection after Elective Colorectal Operation. Surg Infect (Larchmt). 2017;18(3):311-318.
Iwata E, Shigematsu H, Koizumi M, Nakajima H. Lymphopenia and Elevated Blood C-Reactive Protein Levels at Four Days Postoperatively Are Useful Markers for Early Detection of Surgical Site Infection Following Posterior Lumbar Instrumentation Surgery. Asian Spine J. 2016;10(2):220-225.
Aljabi Y, Manca A, Ryan J, Elshawarby A. Value of procalcitonin as a marker of surgical site infection following spinal surgery. Surgeon. 2019;17(2):97-101.