BACKGROUND: This study was to clarify the high risk factors for subphrenic infection (SI) after liver resection for patients with hepatic malignancy.
METHODS: Three hundred and sixty-eight patients who had undergone hepatectomy from January 1985 through June 2002 were randomly divided into 2 groups according to resection of liver parenchyma, hepatic cirrhosis, primary liver cancer, intraoperative blood loss, and subphrenic drainage. The chi-square was used for statistical analysis.
RESULTS: Thirteen patients (3.53%) of the 368 patients had SI. The high-risk factors for SI after hepatectomy were related to resection of liver parenchyma and hepatic cirrhosis; but the course or stage of primary liver cancer was not related to the incidence of SI. Intraoperative blood loss of over 1500 ml was found to be a significant risk factor for postoperative SI. Adequate drainage of the subdiaphragm and the raw surface of the liver after operation was essential to decreasing SI after liver resection.
CONCLUSION: Inadequate subphrenic drainage may largely contribute to SI in patients with hepatic malignancy undergoing hepatectomy apart from other factors. Comprehensive measures should be taken to prevent the infection after hepatectomy.