Early drain fluid lymphocyte fraction as a predictor of postoperative infectious complications after hepatectomy.

PURPOSE: Postoperative infectious complications remain one of the most common morbidities after hepatectomy. We conducted this study to evaluate whether the lymphocyte fraction in drain fluid could serve as a surrogate marker of postoperative infectious complications after hepatectomy.

METHODS

The subjects of this retrospective analysis were 265 patients who underwent hepatectomy. Drain fluid samples were collected on postoperative day (POD) 1, for biochemical and hematologic evaluation. The associations between the lymphocyte fraction in drain fluid and postoperative infectious complications were examined using univariate and multivariate logistic regression analyses.

RESULTS

Postoperative infectious complications developed in 43 patients (16%). Multivariate analysis identified biliary reconstruction (odds ratio (OR) 4.20, p = 0.02), total bilirubin concentration in drain fluid ≥ 1.0 mg/dL (OR 3.32, p < 0.01), and lymphocyte fraction in drain fluid < 0.7% (OR 4.09, p < 0.01) as independent risk factors. No correlation was found between peripheral blood and drain fluid lymphocyte fractions (r = 0.02, p = 0.77).

CONCLUSION

A reduced lymphocyte fraction in drain fluid on POD1 is an independent predictor of postoperative infectious complications after hepatectomy and may reflect the postoperative local immune environment rather than systemic immunity.