{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T03:18:33Z","timestamp":1792725513421,"version":"4.5.0"},"reference-count":47,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2020,3,19]],"date-time":"2020-03-19T00:00:00Z","timestamp":1584576000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Surgical Infections"],"published-print":{"date-parts":[[2020,4,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Despite advances in surgical techniques and peri-operative management, post-operative infectious complications still are common after perihilar cholangiocarcinoma (PHCC). This study investigated the predictive factors and microbial spectrum for infections after hepatectomy with cholangiojejunostomy performed to treat PHCC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A total of 70 consecutive patients, who underwent hepatectomy with cholangiojejunostomy by the same surgeons at a tertiary referral medical center between September 2010 and January 2019, were enrolled. Clinical data were reviewed for multivariable analysis to find independent risk factors for infectious complications. Microorganisms isolated from bile and infection sites were counted to explore the microbial spectrum.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 43 patients (61.4%) suffered post-operative infections (33 with surgical site infection [SSI], four with bacteremia, three with pneumonia, 10 with cholangitis, and two with fungus infectious stomatitis), and 28 of them (65.1%) had a positive bile culture. Four independent risk factors were identified: male sex (odds ratio [OR] 12.737; 95% confidence interval [CI] 2.298\u201370.611; p\u2009=\u20090.004), red blood cell (RBC) count &lt;3.8\u2009\u00d7\u200910\n                      <jats:sup>12<\/jats:sup>\n                      \/L (OR 5.085; 95% CI 1.279\u201320.211; p\u2009=\u20090.021), total cholesterol (TC) &lt;2.90\u2009mmol\/L (OR 5.715; 95% CI 1.534\u201321.299; p\u2009=\u20090.009), and serum Na\n                      <jats:sup>+<\/jats:sup>\n                      &gt;145\u2009mmol\/L (OR 10.387; 95% CI 1.559\u201369.201; p\u2009=\u20090.016) on post-operative day (POD) 1. A total of 217 and 196 microorganisms were cultured from 311 and 627 specimens, respectively, collected from pre-\/intra-operative bile and possible infection sites.\n                      <jats:italic toggle=\"yes\">Staphylococcus<\/jats:italic>\n                      ,\n                      <jats:italic toggle=\"yes\">Enterococcus<\/jats:italic>\n                      ,\n                      <jats:italic toggle=\"yes\">Acinetobacter, Streptococcus,<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">Escherichia<\/jats:italic>\n                      were the most common findings of bile culture. The first five organisms most frequently isolated from infection sites were\n                      <jats:italic toggle=\"yes\">Enterococcus, Staphylococcus, Klebsiella, Acinetobacter,<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">Candida<\/jats:italic>\n                      . A total of 18 patients (64.3%) had at least one species isolated from infection sites that had appeared in a previous bile culture.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Male sex, erythrocytopenia, hypocholesterolemia, and hypernatremia on POD 1 are independent risk factors for infectious complications. For patients without positive bile cultures, third-generation cephalosporins could be considered as the prophylactic antibiotic. It is important to monitor the pathogens throughout the hospital stay.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/sur.2019.199","type":"journal-article","created":{"date-parts":[[2019,11,11]],"date-time":"2019-11-11T10:18:29Z","timestamp":1573467509000},"page":"275-283","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Predictive Factors and Microbial Spectrum for Infectious Complications after Hepatectomy with Cholangiojejunostomy in Perihilar Cholangiocarcinoma"],"prefix":"10.1177","volume":"21","author":[{"given":"Xiaoyuan","family":"Chen","sequence":"first","affiliation":[{"name":"Drum Tower Clinical Medical School, Nanjing Medical University, Nanjing, Jiangsu, P.R. China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiquan","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery, Nanjing University Medical School Affiliated Nanjing Drum Tower Hospital, Nanjing, Jiangsu, P.R. China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaopeng","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery, Nanjing University Medical School Affiliated Nanjing Drum Tower Hospital, Nanjing, Jiangsu, P.R. China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xu","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery, Nanjing University Medical School Affiliated Nanjing Drum Tower Hospital, Nanjing, Jiangsu, P.R. China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinyin","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery, Nanjing University Medical School Affiliated Nanjing Drum Tower Hospital, Nanjing, Jiangsu, P.R. China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dayu","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Nanjing University Medical School Affiliated Nanjing Drum Tower Hospital, Nanjing, Jiangsu, P.R. China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yudong","family":"Qiu","sequence":"additional","affiliation":[{"name":"Drum Tower Clinical Medical School, Nanjing Medical University, Nanjing, Jiangsu, P.R. China."},{"name":"Department of Hepatobiliary and Pancreatic Surgery, Nanjing University Medical School Affiliated Nanjing Drum Tower Hospital, Nanjing, Jiangsu, P.R. China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liang","family":"Mao","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery, Nanjing University Medical School Affiliated Nanjing Drum Tower Hospital, Nanjing, Jiangsu, P.R. China."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,3,19]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/liv.14095"},{"key":"e_1_3_2_3_2","unstructured":"National Comprehensive Cancer Network (NCCN). NCCN Clinical Practice Guidelines in Oncology: Hepatobiliary Cancers. Version 2.2019. Available at:. https:\/\/www.nccn.org Accessed 6 March 2019."},{"key":"e_1_3_2_4_2","first-page":"18","article-title":"Hilar cholangiocarcinoma: Diagnosis, treatment options, and management","volume":"3","author":"Soares KC","year":"2014","unstructured":"Soares KC, , Kamel I, , Cosgrove DP, et al. 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