Intraperitoneal Purulent-Septic Complications in Surgery of Organs of the Hepatopancreatobiliary Zone: Possibilities of Modern Methods of Correction

Introduction . The increase in surgical activity for diseases of the hepatopancreatobiliary system has also led to a higher frequency of postoperative complications. The development of postoperative intra-abdominal purulentseptic complications is one of the main causes of adverse outcomes, which necessitates the improvement of their management methods. The aim of this study was to analyze a large clinical dataset in order to evaluate the incidence and structure of intraabdominal purulent-septic complications after hepatopancreatobiliary surgery. Materials and methods. A large clinical dataset (4,292 cases) collected over five years was analyzed. The overall incidence of postoperative complications after hepatopancreatobiliary surgery was 4.7% (202 out of 4,292). Among these, purulent-septic complications accounted for 55.9%, or 2.63% of all procedures. Results . Among postoperative purulent-septic complications, the most common were suppurative cholangitis (23.0%), infected biliary leaks (19.5%), liver abscesses (15.9%) and perihepatic abscesses (14.2%). Less frequent were peritonitis (10.6%), abscesses of the omental bursa (8.8%), and incomplete intestinal fistulas (8.0%). Discussion . Advances in surgical technology, anesthetic and intensive care support, as well as improvements in the techniques of both primary and repeat hepatopancreatobiliary interventions, have led to a significant reduction in postoperative purulent-inflammatory complications (to 2.63%, compared with 5–6% according to annual reports from the previous five years). Conclusion . The potentially serious outcomes of postoperative purulent-septic complications require further refinement of preventive measures and management strategies.