腹腔镜中转开腹胆囊切除术后手术部位感染情况及危险因素分析

Risk Factors for Surgical Site Infection after Conversion from Laparoscopic to Open Cholecystectomy

目的探讨腹腔镜中转开腹胆囊切除术后手术部位感染的概率及其高危因素。方法回顾性分析2014年1月至2019年8月北京协和医院收治的179例行腹腔镜中转开腹胆囊切除术患者的临床资料,统计手术部位感染的概率,分析手术部位感染的影响因素。结果179例患者中,34例(19.0%)术后出现手术部位感染。多因素分析表明,术前行内镜逆行性胰胆管造影(ERCP)是腹腔镜中转开腹胆囊切除术后手术部位感染的高危因素(OR=4.208,95%CI:1.590~11.135,P=0.004)。结论腹腔镜中转开腹胆囊切除术,尤其是术前行ERCP的患者,术后手术部位感染的风险显著增加,应采取预防性的干预措施来降低其发生率。

Objective To investigate the incidence of surgical site infection(SSI)following conversion from laparoscopic to open cholecystectomy and to analyze the related risk factors.Methods The clinical data of 179 patients who had experienced conversion from laparoscopic to open cholecystectomy in Peking Union Medical College Hospital from January 2014 to August 2019 were analyzed retrospectively.Univariate and multivariate logistic regression analyses were performed to evaluate the associations between clinical variables and SSI.Results The incidence of SSI was 19.0%(34/179)after conversion from laparoscopic to open cholecystectomy.The multivariable analysis demonstrated that preoperative endoscopic retrograde cholangiopancreatography(ERCP)(OR=4.208,95%CI:1.590-11.135,P=0.004)was the only independent risk factor of SSI.Conclusions The incidence of SSI after conversion from laparoscopic to open cholecystectomy increased remarkably,especially in those who had preoperative ERCP.Preventive interventions should be taken to reduce the incidence of SSI.