OBJECTIVE To explore the value of preoperative serum laboratory indicators in the diagnosis of postoperative abdominal infection in patients with perihilar cholangiocarcinoma.

METHODS We retrospectively collected 444 patients who underwent radical resection of perihilar cholangiocarcinoma at the First Medical Center of the People′s Liberation Army General Hospital from Jan. 2021 to Apr. 2023. According to whether postoperative abdominal cavity infection occurred, patients were divided into an infection group (52 cases) and a no-infection group (392 cases). The general clinical data, intraoperative and postoperative conditions of the two patient groups were compared. Multivariate logistic regression analysis was employed to investigate the predictive value of preoperative laboratory indicators in the diagnosis of postoperative abdominal infections.

RESULTS The abdominal cavity infection rate was 11.71% in patients undergoing radical resection of perihilar cholangiocarcinoma. Compared with the non-infection group, the infection group had significantly higher intraoperative red blood cell transfusion volumes, higher incidence rates of postoperative biliary fistula and a longer postoperative hospital stay (P < 0.05). Preoperative serum total protein, C-reactive protein(CRP), carcinoembryonic antigen(CEA), carbohydrate antigen (CA)125, CA15-3, and CA72-4 were independent risk factors in predicting postoperative abdominal cavity infection in patients with perihilar cholangiocarcinoma (P < 0.05). The receiver operating characteristic (ROC) analysis results showed that the area under the curve (AUC) value of the combination of these six indicators for diagnosing postoperative abdominal cavity infection in perihilar cholangiocarcinoma was 0.873 (95%CI: 0.818-0.929), with a sensitivity of 73.1% (95%CI: 0.590-0.844) and a specificity of 87.0% (95%CI: 0.833-0.902).

CONCLUSION Preoperative peripheral blood CRP, total protein and tumor markers of patients with perihilar cholangiocarcinoma have high diagnostic values for postoperative abdominal cavity infection.