Meng HJ, Chen ZH, Nie GM, Ji ZS, Wang YJ, Hu YF, Tang J. Epidemiology and risk of pulmonary complications following hepatobiliary surgical procedures: A retrospective study. World J Gastrointest Surg 2025; 17(9): 109631 [DOI: 10.4240/wjgs.v17.i9.109631]
Corresponding Author of This Article
Jing Tang, Department of Pharmacy, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, No. 168 Litang Road, Changping District, Beijing 102218, China. tja00149@btch.edu.cn
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Sep 27, 2025; 17(9): 109631 Published online Sep 27, 2025. doi: 10.4240/wjgs.v17.i9.109631
Epidemiology and risk of pulmonary complications following hepatobiliary surgical procedures: A retrospective study
Hui-Jie Meng, Zhong-Hao Chen, Guang-Meng Nie, Zhao-Shuai Ji, Yu-Jie Wang, Yong-Fang Hu, Jing Tang
Hui-Jie Meng, Zhao-Shuai Ji, Jing Tang, Department of Pharmacy, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, Beijing 102218, China
Zhong-Hao Chen, THiFLY Research, Tsinghua University, Beijing 102218, China
Guang-Meng Nie, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, Beijing 102218, China
Yu-Jie Wang, Medical Data Science Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, Beijing 102218, China
Yong-Fang Hu, Department of Clinical Pharmacy, School of Clinical Medicine, Tsinghua University, Beijing 102218, China
Co-corresponding authors: Yong-Fang Hu and Jing Tang.
Author contributions: Meng HJ drafted manuscript; Meng HJ and Chen ZH collected data; Nie GM and Ji ZS guide research development and revised the manuscript; Wang YJ analyzed data; Hu YF designed the study and revised the article; Tang J performed the research and revised the manuscript; Hu YF and Tang J contributed equally to this manuscript as co-corresponding authors; and all authors have reviewed and approved the final manuscript.
Supported by the Beijing Tsinghua Changgung Hospital Fund, China, No. 12023C01005.
Institutional review board statement: This study was approved by the Medical Ethics Committee of Beijing Tsinghua Changgung Hospital, Affiliated with Tsinghua University, No. 23643-0-01.
Informed consent statement: The need for patient consent was waived due to the retrospective nature of the study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The data to support the findings of this study are available from the corresponding author upon request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jing Tang, Department of Pharmacy, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, No. 168 Litang Road, Changping District, Beijing 102218, China. tja00149@btch.edu.cn
Received: May 19, 2025 Revised: June 6, 2025 Accepted: August 1, 2025 Published online: September 27, 2025 Processing time: 131 Days and 2.4 Hours
Abstract
BACKGROUND
Postoperative pulmonary complications (PPCs) are the most common complications following major upper abdominal surgeries, particularly hepatobiliary procedures, and significantly compromise surgical outcomes and patients’ quality of life. Although the adoption of laparoscopy has lowered their incidence, PPCs remain a frequent and serious concern after hepatobiliary surgery. Existing research on risk factors specific to hepatobiliary surgeries is limited, particularly regarding the epidemiology and risk factors of PPCs in liver and gallbladder surgeries in China. Therefore, this study aimed to investigate the risk factors for PPCs in a large hepatobiliary center.
AIM
To identify the incidence and risk factors for PPCs following hepatobiliary surgery based on perioperative variables.
METHODS
Retrospective data were collected from patients who underwent liver, gallbladder, or pancreatic surgery at a hepatobiliary center in China between May 2023 and December 2023. We retrospectively reviewed comprehensive medical records to extract demographic and hospital admission information for determining PPC incidence. Statistically significant variables were initially screened through univariate analysis, followed by binary logistic regression modeling to identify independent predictors of PPCs. Hospitalization expenditures and duration of stay were further contrasted across the study cohorts.
RESULTS
This study included 1941 patients who underwent liver, gallbladder, or pancreatic surgery, of whom 78 developed PPCs, resulting in an incidence rate of 4.02%. Logistic regression analysis revealed two independent predictors of PPCs in hepatobiliary surgery patients: Age ≥ 75 year (odds ratio = 8.350, 95%CI: 3.521-19.798, P < 0.001) and prolonged anesthesia (odds ratio = 1.052, 95%CI: 1.015-1.091, P = 0.006). Patients with PPCs had significantly elevated healthcare resource utilization, including higher total hospitalization costs, increased medication expenses, longer hospital stays, and extended postoperative admissions (all P < 0.001).
CONCLUSION
Age ≥ 75 years and prolonged anesthesia emerged as independent predictors of PPCs following hepatobiliary surgery. These complications were correlated with protracted hospitalization and increased healthcare costs.
Core Tip: This study identifies two independent risk factors for postoperative pulmonary complications (PPCs) following hepatobiliary surgery: Age ≥ 75 years and prolonged anesthesia. Conducted in a large Chinese hepatobiliary center, the retrospective analysis of 1941 patients revealed an incidence rate of PPCs at 4.02%. Patients with PPCs experienced significantly higher hospitalization costs, medication expenses, and longer lengths of stay compared to those without complications. These findings underscore the need for targeted interventions to mitigate PPCs in high-risk populations and improve surgical outcomes.
