Predictive factors for bile leakage after hepatectomy: analysis of 505 consecutive patients

World J Surg. 2011 Aug;35(8):1898-903. doi: 10.1007/s00268-011-1114-7.

Abstract

Background: Bile leakage is the most common complication after hepatectomy and its incidence is not declining. The aim of the present study was to identify predictive factors for bile leakage.

Methods: Clinical data from 505 consecutive patients who underwent hepatectomy without extrahepatic bile duct resection in our department between January 2006 and December 2009 were reviewed retrospectively.

Results: The incidence of bile leakage was found to be 6.7%. Multivariate analysis identified three independent factors that were significantly correlated with the occurrence of bile leakage: (1) repeat hepatectomy (P = 0.002; odds ratio [OR] 3.439; 95% confidence interval [CI] 1.552-7.618), (2) a cut surface area ≥57.5 cm(2) (P = 0.004; OR 5.296; 95% CI 1.721-16.302), and (3) intraoperative blood loss ≥775 ml (P = 0.01; OR 2.808; 95% CI 1.280-6.160).

Conclusion: More meticulous management is needed to prevent bile leakage in high-risk patients.

Publication types

  • Historical Article

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bile Duct Neoplasms / surgery*
  • Bile Ducts, Intrahepatic
  • Bile*
  • Carcinoma, Hepatocellular / surgery*
  • Cholangiocarcinoma / surgery*
  • Colorectal Neoplasms / surgery*
  • Cross-Sectional Studies
  • Female
  • Gallbladder Neoplasms / surgery*
  • Hepatectomy / adverse effects*
  • Hepatectomy / methods
  • History, 16th Century
  • History, 17th Century
  • History, 18th Century
  • Humans
  • Liver Diseases / epidemiology*
  • Liver Diseases / etiology*
  • Liver Neoplasms / secondary*
  • Liver Neoplasms / surgery*
  • Male
  • Middle Aged
  • ROC Curve
  • Reoperation
  • Retrospective Studies
  • Risk Factors