Poor postoperative blood glucose control increases surgical site infections after surgery for hepato-biliary-pancreatic cancer: a prospective study in a high-volume institute in Japan

J Hosp Infect. 2008 Mar;68(3):230-3. doi: 10.1016/j.jhin.2007.12.002. Epub 2008 Feb 21.


Two hundred and sixty-five consecutive patients awaiting hepato-biliary-pancreatic surgery were prospectively observed for surgical site infections (SSIs). SSI rates differed according to type of hepato-biliary-pancreatic surgery. Multivariate analysis identified enteric anastomoses, poor postoperative blood glucose control and type of cancer as independent risk factors. SSI rates were directly correlated with the degree of hyperglycaemia encountered during the postoperative period. In particular, SSI rates were 5/25 (20%) among patients in whom a blood glucose level of <200mg/dL was maintained by insulin infusion therapy, which was significantly better than the rates of 49/94 (52%) among patients in whom a blood glucose level of <200mg/dL was not maintained despite insulin infusion therapy (P<0.01). It is necessary to maintain postoperative blood glucose levels of <200mg/dL in order to reduce SSI rates.

MeSH terms

  • Biliary Tract Neoplasms / surgery*
  • Blood Glucose / drug effects*
  • Digestive System Surgical Procedures / adverse effects*
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Insulin / therapeutic use
  • Japan / epidemiology
  • Liver Neoplasms / surgery*
  • Pancreatic Neoplasms / surgery*
  • Postoperative Period
  • Prospective Studies
  • Surgical Wound Infection / epidemiology
  • Surgical Wound Infection / metabolism*


  • Blood Glucose
  • Hypoglycemic Agents
  • Insulin