Liu Y, Chen L. Severe postoperative infections following surgery for digestive system diseases. World J Gastrointest Surg 2026; 18(8): 121379 [DOI: 10.4240/wjgs.121379]
Corresponding Author of This Article
Li Chen, MD, Department of Critical Care Medicine, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, No. 280 Mohe Road, Baoshan District, Shanghai 201900, China. wwqh480@163.com
Research Domain of This Article
Gastroenterology & Hepatology
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research-article
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Liu Y, Chen L. Severe postoperative infections following surgery for digestive system diseases. World J Gastrointest Surg 2026; 18(8): 121379 [DOI: 10.4240/wjgs.121379]
World J Gastrointest Surg. Aug 27, 2026; 18(8): 121379 Published online Aug 27, 2026. doi: 10.4240/wjgs.121379
Severe postoperative infections following surgery for digestive system diseases
Ya Liu, Li Chen
Ya Liu, Li Chen, Department of Critical Care Medicine, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201900, China
Author contributions: Liu Y designed the study, performed the literature review, collected and analyzed the data, and drafted the manuscript; Chen L supervised the study and critically revised the manuscript for important intellectual content. All authors read and approved the final manuscript.
AI contribution statement: No AI tools were used in the preparation of this manuscript.
Institutional review board statement: This study has been reviewed and approved by the Ethics Committee of Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: There are no additional data available.
Corresponding author: Li Chen, MD, Department of Critical Care Medicine, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, No. 280 Mohe Road, Baoshan District, Shanghai 201900, China. wwqh480@163.com
Received: April 28, 2026 Revised: June 4, 2026 Accepted: June 25, 2026 Published online: August 27, 2026 Processing time: 110 Days and 16.1 Hours
Abstract
BACKGROUND
Postoperative infection following digestive system surgery is a critical complication that leads to high rates of morbidity and mortality. Current studies on the incidence and, more importantly, the risk and microbiological factors related to these infections in patients undergoing surgery on the digestive system are lacking. Identifying such factors can aid in detecting patients who may be at post-operative infection risk and enable the modification of perioperative practices.
AIM
To describe the incidence and risk factors of severe postoperative infections, pathogens’ microbiological profile, and infection effects on clinical outcomes.
METHODS
This study is a retrospective cohort of patients who underwent digestive system surgery and attended the chosen hospital. This study enrolled 156 eligible patients. Severe postoperative infection was defined as an infectious complication that occurred within 30 days of surgery and was classified as Clavien-Dindo grade III or higher. The study included relevant demographic, clinical, and laboratory data as well as intraoperative and perioperative microbiological data. Risk factors were examined using univariate and multivariate logistic regression.
RESULTS
Among the 156 patients, 38 developed serious postoperative infections. The most common infections were intra-abdominal (52.6%), followed by surgical site (28.9%) and pulmonary infections (18.4%). Infections were dominated by Gram-negative bacteria (65.9%). Of these, Escherichia coli was responsible for 27.3% and Klebsiella pneumoniae for 18.2%. The following parameters were associated with an increased odds of infection: Diabetes and metabolic syndrome, preoperative serum albumin level < 35 g/L, surgical duration ≥ 240 minutes, and open surgical approach. Patients who developed supervening infections had longer inpatient stays (24.3 days vs 11.6 days, P < 0.001), and those who developed severe infections had a higher 30-day mortality rate (10.5% vs 0.8%, P = 0.004).
CONCLUSION
Digestive surgery leads to severe postoperative infection in a considerable number of patients and causes high morbidity and mortality. These findings support perioperative optimization and locally guided antimicrobial management.
Core Tip: This paper investigates the development of severe infections after surgery of the digestive system by analyzing factors such as patient age, comorbidities, and type of surgery. The study argues that the risk of developing infections after surgery can be mitigated by the timely recognition of symptoms and the initiation of appropriate antibiotic therapy. The study finds that the risk is greater in the case of patients with less immunity and patients who have undergone more complex surgeries. the individual patient and the complex nature of the surgery performed to correct a gastrointestinal problem should be the basis of treatment in order to achieve better results and reduce the incidence of post-operative infections.
