Gastrectomy is Associated with an Increased Risk of Pyogenic Liver Abscess: A 13-Year Nationwide Cohort Study

Abstract

Whether patients who have undergone gastrectomy are at a high risk of developing pyogenic liver abscess (PLA) remains debatable. From the inpatient claims records of Taiwan’s National Health Insurance Research Database, we identified 33 834 patients with a history of 2000–2010 and135 336 controls without a history of gastrectomy. The 2cohorts were matched by age, sex, and admission year and followed-up until the end of 2011 for estimating the risk of PLA. Overall, the incidence of PLA was 3.5-fold higher in the gastrectomy cohort than in the control cohort (21.6 vs 5.76 per 10 000 person-y). The adjusted hazard ratio (aHR) for the gastrectomy cohort obtained using the multivariate Cox proportional hazards regression model was 3.08 (95% confidence interval [CI] = 2.60–3.64). An elevated post gastrectomy PLA risk was observed in both men and women. Age-specific data revealed that the aHR for the gastrectomy cohort, compared with the control cohort, was the highest in patients younger than 50 years (aHR = 5.16, 95% CI = 2.96–9.01). An addition analysis showed that the gastrectomy cohort exhibited an elevated PLA risk regardless of whether the patients underwent total or partial gastrectomy. Patients with a history of gastrectomy exhibit a high risk of PLA.

Predialysis chronic kidney disease correlates with increased risk of pyogenic liver abscess: a population-based cohort study

“…These findings indicate that patients on dialysis therapy seem to be at high risk of developing pyogenic liver abscess than those without dialysis. The incidence of pyogenic liver abscess in our study was lower than that in patients with gastrectomy in Taiwan (138 vs. 216 per 100 000 person-years) [45], and also lower than that in patients with splenectomy in Taiwan (138 vs. 215 per 100 000 person-years) [12]. Of note, the incidence of pyogenic liver abscess in the general population in Taiwan appears to be much higher than that in western countries (13Á5 vs. 2Á3-3Á6 per 100 000 person-years) [14][15][16].…”

Pyogenic Hepatic Abscess Formation after Roux-En-Y Gastric Bypass: A Case Report and Literature Review of an Infrequently Encountered Postoperative Complication

“…About 5% to 15% of these liver infections can be triggered by bacterial inoculation of the liver tissue via the hepatic artery or by direct drainage system of the portal vein [4,5]. In 5%-10% and 1%-5% of instances, direct expansion from an adjacent site of infection and traumatic incidents, respectively, are thought to be the sources of infection [3,6]. The pathogen can penetrate the liver either directly through proximity or via bile duct channels [4,6,7].…”

“…In 5%-10% and 1%-5% of instances, direct expansion from an adjacent site of infection and traumatic incidents, respectively, are thought to be the sources of infection [3,6]. The pathogen can penetrate the liver either directly through proximity or via bile duct channels [4,6,7].…”

“…To diagnose pyogenic hepatic abscesses, radiological investigations are crucial [4,6,8]. These include contrast-enhanced CT scans and ultrasonography with a sensitivity level of 98% [4,6].…”

“…To diagnose pyogenic hepatic abscesses, radiological investigations are crucial [4,6,8]. These include contrast-enhanced CT scans and ultrasonography with a sensitivity level of 98% [4,6]. The main contrastenhanced CT radiological findings are identified as low-attenuation, circular masses with an augmenting peripheral rim [4].…”