Microbiological Findings and Risk Profiles in Hepatobiliary and Pancreatic Surgery Associated Surgical Site Infections: A Retrospective Cohort Study

Surgical site infections (SSIs) are among the most frequent healthcare-associated infections, leading to prolonged hospitalization, increased costs, and impaired recovery. This retrospective cohort study aimed to identify the determinants and microbial patterns of SSIs following hepatobiliary and pancreatic (HPB) surgery to inform preventive strategies and optimize clinical outcomes. The patients undergoing hepatobiliary and pancreatic surgery from 2014 to 2024 in a tertiary university hospital are reviewed. SSI was defined according to Centers for Disease Control and Prevention (CDC) criteria, and microbiological isolates were identified through routine culture methods and susceptibility testing. Clinical, operative, and microbiological data of patients who underwent hepatobiliary and pancreatic surgery were extracted, including demographics, comorbidities, operative characteristics, and postoperative outcomes. Among 553 hepatobiliary and pancreatic surgery patients, SSI occurred in 48.6%. Gram-negative bacteria predominated, with E. coli as the leading pathogen. SSI was linked to open surgery, longer operative time, and higher ASA scores; malignancy, renal insufficiency, anemia, and COPD were independent risk factors. Age by itself was not a reliable predictor of infection, while operative duration demonstrated moderate predictive performance, with a sensitivity of 66%. These findings underscore the multifactorial pathogenesis of SSIs and emphasize the importance of refined perioperative strategies to mitigate postoperative infectious complications.