Aims and Objectives: Our primary aim was to study association between nonsurgical techniques related complications and mortality and our secondary aim was to determine factors responsible for non surgical technique related complications. Material and Methods: All gastrointestinal and hepatobiliary procedures performed in last 3 years have been evaluated retrospectively. Nonsurgical procedure related postoperative complications were defined as perioperative complications nonrelated to surgical procedures or techniques and related to patients’ physiological health or comorbidities. To avoid selection bias in attempt to evaluate effect of non-surgical procedural related complication on mortality, we did 1:1 propensity score matching analysis with nonsurgical technique related complications as dependent factor. Propensity scores were calculated using logistic regression. Pre operative confounding factors like age, sex, American society of Anesthesia score (ASA), emergency surgery, type of surgeries like HPB surgeries, Upper gastrointestinal surgeries, small bowel surgeries, colorectal surgeries, hernia surgeries, open or laparoscopic surgeries were entered in model as covariates. We used nearest neighbor matching protocol with a calipher of 0.2. Cases were not reusable after matching. Statistical analysis was done using SPSS version 23. Results: Total 348 patients underwent various abdominal surgeries (gastrointestinal and hepatobiliary) in our department from April 2017 to March 2020. Total 24 patients developed nonsurgical technique related complications. Before Propensity score matching nonsurgical technique related complications were significantly higher in Upper Gastrointestinal surgeries (gastric and esophageal), emergency surgeries, Open surgeries, in patients who developed intraoperative hypotension, patients operated for malignancies, patients with higher ASA grades, patients in whom more blood products were used and patient who had more operative time. ASA scores independently predicted nonsurgical technique related complications. [P=0.001. Odds Ratio 3.955 (95% C.I.) 1.774-8.813)]. After Matching 24 patients patients were included in nonsurgical complication related complication group and they were compared with 23 matched controls. After matching also nonsurgical procedural related complications were significantly associated with mortality. (p< 0.0001). No intraoperative factors like intraoperative hypotension, blood product requirement, operative time predicted non-surgical technique related complication. Surgery related complications were not associated with mortality after matching. Conclusion: Nonsurgical technique related complications are associated with significant increase risk of mortality.

Aim: Aim of our study to evaluate various factors responsible for surgical site infection after gastrointestinal and hepatobiliary surgeries. Material and Methods: Patient who underwent gastrointestinal and hepatobiliary surgery in our department were evaluated retrospectively. Various factors associated with surgical site infection were evaluated using univariate and multivariate analysis. Surgical site infection was defined as any culture positive discharge from the wound within 30 days of surgery.Statistical analysis was done using SPSS version 23. Results: We evaluated total 331 patients operated between April 2018 to March 2020. 14 patients were lost to follow up after discharge and before completing post operative day 30. 18 patients expired before 30 days without developing SSI and were excluded from the study as per exclusion criteria. 299 patient included in the study. Total 20 patients developed surgical site infection. It showed SSI rate in our study population was 6.68%. On univariate analysis prolonged hospital stay, more blood product used, higher cdc grade of surgery, higher ASA grade, more operative time, open surgeries,colorectal and HPB surgeries were associated with surgical site infections. On multivariate analysis only prolonged hospital stay independently predicted Surgical Site Infectins. (p=0.014,0dds ratio 1.223, 95% confidence interal 1.042-1.435). Conclusion: Prolonged hospital stay independently predicts surgical site infections after gastrointestinal and hepatobiliary surgery.

Aim: Aim of our study was to evaluate incidence and causative factors for acute kidney injury in hepatopancreaticobiliary (HPB) surgeries. Material and Methods: All the HPB surgeries performed between April 2018 to March 2020, in our institution have been analysed for acute kidney injury. Acute kidney injury defined according to acute kidney injury network classification. Categorical variables were evaluated by chi square test and fisher t test wherever approptiate and continuous variables by Mann Whitney U test. Statistical analysis was done using SPSS version 23. P< 0.05 was considered significant. Results: We performed 195 HPB surgeries between April 2018 to March 2020, Which included 114 biliary surgeries, 57 liver surgeries and 23 pancreas surgeries. 10 patients developed Acute Kidney Injuries. (AKI) On Univariate analysis AKI was associated with open surgeries, intra operative hypotension and liver surgeries, higher ASA grade, increase operative time, more blood products used, higher CDC grade of surgery and more hospital stay before diagnosis of AKI. However on multivariate analysis only higher ASA score independently predicted Acute Kidney Injury. (p=0.003, odds ratio 15.659, 95% confidence interval 2.54-93.36). AKI was also significantly associated with mortality. (p <0.0001). Conclusion: Pre operative higher ASA grade independently predicted post operative acute kidney injury. Post operative AKI is significantly associated with mortality.