Risk factors for postoperative pneumonia after hepatectomy with extrahepatic bile duct resection. (23rd June 2022)

• Record Type: Journal Article
• Authors: Uemura, Masao; Ashida, Ryo; Sugiura, Teiichi; Okamura, Yukiyasu; Ohgi, Katsuhisa; Yamada, Mihoko; Otsuka, Shimpei; Notsu, Akifumi; Uesaka, Katsuhiko
• Is Part Of: Journal of hepato-biliary-pancreatic sciences. Volume 30:Number 3(2023)
• Page Start: 383
• Page End: 391
• Publication Date: 2022-06-23
• Subjects: aged -- hepatectomy -- liver failure -- pneumonia -- spirometry; Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 617.556
• DOI: 10.1002/jhbp.1191
• Languages: English
• ISSNs: 1868-6974

Abstract

Abstract: Background: The present study investigated the incidence of postoperative pneumonia (POP) after hepatectomy with extrahepatic bile duct resection (BDR) and elucidated risk factors for POP. Methods: A total of 257 patients undergoing hepatectomy with BDR between 2011 and 2019 were retrospectively reviewed to evaluate the incidence of POP, defined by the Clavien‐Dindo grade ≥ II. The predictive factors for POP were identified using logistic regression analysis of the pre‐ and intraoperative evaluable factors. Results: Postoperative pneumonia developed in 15 patients (5.8%), diagnosed as grade IV or V in five patients. In a multivariate analysis, a vital capacity ratio (%VC) <80% (odds ratio [OR] 7.30, P = .005), age ≥ 74 years old (OR 5.39, P = .026), and future liver volume remnant (FLR) ratio ≤ 40% (OR 4.97, P = .045) were independent risk factors for POP. Among patients with performing spirometry, the incidence of developing POP was 1.0%, 8.8%, and 60% in patients with 0, 1‐2, and 3 risk factors, respectively. Conclusions: The incidence of POP in patients undergoing hepatectomy with BDR was 5.8%. A %VC <80%, age ≥74 years old, and FLR ratio ≤40% were identified as preoperative predictive factors of developing POP. Abstract : Uemura et al. investigated the details of postoperative pneumonia in 257 patients undergoing hepatectomy with extrahepatic bile duct resection. The incidence of pneumonia was 5.8% and risk classification with risk factors was useful for stratifying patients. Pneumonia was associated with liver failure, and carried a risk of fatal outcomes.