Risk factors for pulmonary complications after laparoscopic liver resection: a multicenter retrospective analysis

Background Postoperative pulmonary complications (PPCs) are among the most common complications after liver resection. Although the application of laparoscopy has reduced the incidence of PPCs, the rate of PPCs after laparoscopic liver resection (LLR) remains high and the risk factors for the same are unclear. Therefore, this study aimed to determine the risk factors for PPCs after LLR. Methods In this multicenter study, 296 patients underwent LLR from January 2019 to December 2020. Demographic data, pathological variables, and perioperative variables were reviewed. Univariate and multivariate analyses were performed to identify the independent risk factors for PPCs. Results Of the 296 patients, 80 (27.0%) developed PPCs. Patients with PPCs had significantly increased total costs, operation costs, length of stays, and postoperative hospital stays. Multivariate analysis identified three independent risk factors for PPCs after LLR: smoking [Odds ratio (OR): 5.413, 95% confidence intervals (CI): 2.446–11.978, P = < 0.001], location of lesion in segment 7 or 8 (OR 3.134, 95% CI 1.593–6.166, P = 0.001), duration of liver ischemia (OR 1.038, 95% CI 1.022–1.054, P < 0.001), and presence of intraoperative hypothermia (OR 3.134, 95% CI 1.593–6.166, P < 0.001). Conclusion Smoking, location of lesion in segment 7 or 8, duration of liver ischemia and intraoperative hypothermia were independent risk factors for PPCs which significantly increased the length of stays and burden of healthcare costs.