Infectious complications after liver resection in patients with prior biliary-enteric anastomosis: a multicenter retrospective cohort study.

Authors

Hayata Sano, Takeshi Urade, Atsushi Takebe, Motofumi Tanaka, Shohei Komatsu, Hidetoshi Gon, Kenji Fukushima, Shinichi So, Toshihiko Yoshida, Keisuke Arai, Kosuke Iguchi, Kentaro Tai, Hisoka Yamane, Kentaro Oji, Masahiro Kido, Ippei Matsumoto, Takumi Fukumoto

Published in

HPB : the official journal of the International Hepato Pancreato Biliary Association. Sep 19, 2026. Epub Sep 19, 2026.

Abstract

Liver resection in patients with prior biliary-enteric anastomosis (BEA) is associated with high rates of infectious complications. We evaluated the incidence, patterns, and risk factors.
This multicenter retrospective study included patients with prior BEA who underwent liver resection at three Japanese institutions between 2008 and 2025. The primary endpoint was organ/space surgical site infection (SSI) within 30 days postoperatively. Univariable analyses were performed to identify factors associated with organ/space SSI, comparing patients with and without this complication.
Among the 26 patients, pancreatoduodenectomy was the most common preceding BEA procedure. Organ/space SSI occurred in 10 patients, and overall infectious complications occurred in 13 patients, including 3 with other infections. Cultures were positive in 6 of 10 organ/space SSI cases, and all isolates were enteric organisms. Organ/space SSI occurred more frequently with concave-type than flat-type transection surface morphology (8 of 13 vs. 2 of 13; P = 0.041). Organ/space SSI was associated with significantly prolonged postoperative hospital stay (median [range], 28.5 [13-94] vs. 13 [6-105] days; P = 0.003).
Liver resection after BEA carries a substantial risk of postoperative organ/space SSI. Concave transection surface morphology may represent a clinically relevant risk factor in this high-risk population.

PMID:
42827057
Bibliographic data and abstract were imported from PubMed on 03 Oct 2026.

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