+ Site Statistics
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Risk factors and management of postoperative bile leakage after hepatectomy without bilioenteric anastomosis

Risk factors and management of postoperative bile leakage after hepatectomy without bilioenteric anastomosis

Digestive Surgery 28(3): 198-204

Bile leakage frequently causes major complications after hepatic resection. We investigated perioperative risk factors and management of postoperative bile leakage after hepatic resection without extrahepatic biliary resection and reconstruction. We included 247 consecutive patients who underwent elective hepatic resection without bilioenteric anastomosis at our institution between 2002 and 2009. Perioperative risk factors, including patient and surgical variables, were evaluated using univariate and logistic regression analyses. Postoperative bile leakage occurred in 26 patients (10.5%). The surgical drain was retained in 6 patients (23%); 9 (35%) underwent drain salvage and 11 (42%) underwent percutaneous puncture under computed tomography or ultrasound guidance. Eight patients underwent endoscopic nasobiliary drainage (ENBD) for postoperative bile leakage, and bile leakage healed at a median interval of 19.5 days after ENBD. By univariate analysis, postoperative bile leakage was associated with central bisectionectomy, surgical time and intraoperative blood loss. Logistic regression analysis identified central bisectionectomy as an independent risk factor for postoperative bile leakage (p = 0.0003, odds ratio 16.724). Meticulous procedures are necessary during parenchymal hepatic resection, especially during central bisectionectomy. Drain management should be precise in the case of postoperative bile leakage. We believe ENBD may rapidly cure postoperative major bile leakage.

(PDF emailed within 0-6 h: $19.90)

Accession: 055579171

Download citation: RISBibTeXText

PMID: 21540607

DOI: 10.1159/000324042

Related references

The clinical risk factors associated with postoperative bile leakage after hepatectomy: a meta-analysis. Minerva Medica 107(1): 39-53, 2016

Bile leakage after hepatectomy for hepatolithiasis: risk factors and management. Surgery 141(3): 340-345, 2007

Risk factors for bile leakage after hepatectomy. Hepatobiliary & Pancreatic Diseases International 15(1): 12-13, 2016

Risk Factors and Managements of Bile Leakage After Hepatectomy. World Journal of Surgery 40(1): 182-189, 2016

Risk factors of bile leakage after hepatectomy for hepatocellular carcinoma. Hepato-Gastroenterology 60(127): 1717-1719, 2014

Incidence, risk factors and consequences of bile leakage following laparoscopic major hepatectomy. Surgical Endoscopy 30(9): 3709-3719, 2017

Analyzing risk factors for early postoperative bile leakage based on Clavien classification in bile duct stones. International Journal of Surgery 12(8): 757-761, 2015

Independent Risk Factors That Predict Bile Leakage After Hepatectomy For Hepatocellular Carcinoma: Cohort Study. International Journal of Surgery: -, 2018

Risk factors and a simple model for predicting bile leakage after radical hepatectomy in patients with hepatic alveolar echinococcosis. Medicine 96(46): E8774-E8774, 2017

Clinical risk factors for postoperative bile leakage after liver resection. International Surgery 95(3): 232-238, 2010

Percutaneous transhepatic ethanol ablation for postoperative bile leakage after a hepatectomy. Hepato-Gastroenterology 58(107-108): 988-991, 2011

Postoperative bile leakage inhibits liver regeneration after 70% hepatectomy in rats. Journal of Investigative Surgery 26(1): 36-45, 2013

Risk factors for postoperative bile leakage: a retrospective single-center analysis of 411 hepatectomies. Hepatobiliary & Pancreatic Diseases International 15(1): 81-86, 2016

Preoperative, intraoperative and postoperative risk factors for anastomotic leakage after laparoscopic low anterior resection with double stapling technique anastomosis. World Journal of Gastroenterology 22(25): 5718-5727, 2016

Liver abscess after transarterial chemoembolization in patients with bilioenteric anastomosis: frequency and risk factors. Ajr. American Journal of Roentgenology 200(6): 1370-1377, 2013