Pathogenic characteristics and risk factors of postoperative abdominal infection in patients after laparoscopic pancreaticoduodenectomy

Objective To analyze the risk factors and pathogenic characteristics of abdominal infection in patients after laparoscopic pancreaticoduodenectomy (LPD). Methods A total of 133 patients who underwent LPD between January 2021 and March 2023 at Department of Hepatobiliary Surgery, the Affiliated Hospital Xuzhou Medical University were selected as subjects. Before surgery, reduced jaundice, preoperative albumin levels, surgical duration, intraoperative blood loss, postoperative abdominal fluid culture results, drain amylase levels, and postoperative pulmonary and abdominal imaging findings, were observed. The pathogenic characteristics and risk factors of postoperative abdominal infection were analyzed. Results Abdominal infection occurred in 38 patients after LPD, with an infection rate of 28.6%. A total of 83 pathogenic strains were identified, including 43 Gram-negative (G^-) bacteria, 38 Gram-positive (G⁺) bacteria, and 2 fungi. Univariate analysis showed that the occurrence of postoperative abdominal infection was associated with preoperative albumin level, surgical duration, postoperative pulmonary infection, and postoperative pancreatic fistula (P<0.05). Logistic regression analysis revealed that preoperative albumin levels <30 g/L, pancreatic fistula, and pulmonary infection were independent risk factors for postoperative abdominal infection following LPD. Conclusions Abdominal infection after LPD is predominantly caused by G^- bacteria, most of which are multidrug-resistant. Preoperative albumin control and postoperative pancreatic fistula and pulmonary infection control, are crucial to prevent postoperative abdominal infection.