To analyze the risk factors for infectious complications following open hepatectomy in patients with hepatocellular carcinoma (HCC).

Clinical data of 63 patients with HCC who underwent elective open hepatectomy in Guangzhou Eighth People’s Hospital from January 2023 to October 2025 were retrospectively collected. Patients were divided into an infection group (15 patients) and a non-infection group (48 patients) based on the occurrence of postoperative infectious complications. Univariate analysis and multivariate Logistic regression analysis were used to identify independent risk factors.

Among the 63 patients, 15 (23.81%) developed postoperative infectious complications, including intra-abdominal infection in 8 cases (53.33%), surgical site infection in 6 cases (40.00%), and pulmonary infection in 1 case (6.67%). Univariate analysis showed statistically significant differences between the two groups in preoperative serum albumin, total bilirubin, ascites, nutritional risk screening 2002 (NRS 2002) score (NRS-2002≥3 points), and Child-Pugh grade (all P<0.05). Multivariate Logistic regression analysis revealed that low preoperative serum albumin (OR=0.70, 95% CI： 0.56–0.89, P=0.003) and high level of preoperative total bilirubin (OR=1.13, 95% CI： 1.03–1.24, P=0.011) were independent risk factors for infectious complications after open hepatectomy in HCC patients.

Low preoperative serum albumin level and high preoperative total bilirubin level are independent risk factors for infectious complications following open hepatectomy in patients with HCC. Perioperative monitoring and intervention targeting serum albumin and total bilirubin should be strengthened to reduce the risk of postoperative infection.