A systematic review on the incidence and risk factors of surgical site infections following hepatopancreatobiliary (HPB) surgery

Abstract

Background: Surgical site infections (SSI) are one of the most common hospital acquired infections and result in increased morbidity, mortality and financial burden on health services. The incidence of SSIs are not clearly defined and infection rates as varied as 20%–40% have been reported. The aim of this study was to systematically review the incidence and risk factors of SSI following HPB surgery. Methods: The database of Medline (via PubMed) was systematically searched from 2013–2022. Articles were screened using the PRISMA statement and those that met the inclusion criteria were included in the study. Results: Sixteen studies were eligible for inclusion in this systematic review. The average incidence of SSI was 29.8%. Key risk factors identified included male gender, open surgery, preoperative biliary stenting and obesity. Conclusions: The incidence of SSI following HPB surgery varied, but it is generally high. A variety of pre-disposing patient factors can affect infection rates following HPB surgery. The results from this study suggest that perhaps laparoscopic surgery should be used where possible, and that there should be an awareness that gender, obesity and the use of stents may increase the incidence of SSIs following these operations.

Keywords

• surgical site infection
• hospital acquired infection
• surgery
• hepatopancreatobiliary
• incidence
• risk factor