Bone, Madeline, Latimer, Sharon, Walker, Rachel M., Thalib, Lukman, and Gillespie, Brigid M. (2024) Risk factors for surgical site infections following hepatobiliary surgery: An umbrella review and meta-analyses. European Journal of Surgical Oncology, 51 (1). 109468.

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Abstract

Background: In the hepatobiliary (HPB) surgical cohort, surgical site infections (SSI) can extend hospital stays, result in higher morbidity, and poor patient outcomes. This umbrella review and meta-analysis aimed to synthesise the evidence for the association between clinical and patient risk factors and SSI in patients following HPB surgery.

Methods: We searched MEDLINE, CINAHL, EMBASE and Scopus from January 2000 to April 2023 to identify systematic reviews and meta-analyses where patient and/or clinical factors of SSIs following HPB surgery were reported. The summary effect size, its 95 % CI and the 95 % PI were calculated for each meta-analysis using random-effects models. 30-day cumulative SSI incidence was presented as the pooled estimate with 95 % CIs. Between-study heterogeneity was explored using the I 2 statistic.

Results: Nine systematic reviews and meta-analyses were included. Our findings suggest open surgical approach, type of pancreas procedure, preoperative biliary drainage, older age, male sex and high BMI (>25mg/k) as statistically significant factors for increasing a patient’s risk of SSI following HPB surgery. The cumulative incidence of SSI in the HPB cohort of 43,296 was 11 % (95 % CI 6%–20 %), with substantial variation between the reviews.

Conclusion: We identified several patient and clinical factors, however only one was graded as a high level of evidence.

Item ID:	91112
Item Type:	Article (Research - C1)
ISSN:	1532-2157
Copyright Information:	© 2024 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)
Date Deposited:	07 Apr 2026 00:33
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