Risk factors for postoperative bile leakage:a retrospective single-center analysis of 411 hepatectomies

作     者：Fabrizio Panaro Lisa Hacina Hassan Bouyabrine Al-Warith Al-Hashmi Astrid Herrero Francis Navarro 

作者机构：Department of General and Liver Transplant SurgeryMontpellier University HospitalCollege of Medicine 

出 版 物：《Hepatobiliary & Pancreatic Diseases International》 (国际肝胆胰疾病杂志（英文版）)

年 卷 期：2016年第15卷第1期

页      面：81-86页

核心收录：

学科分类：1002[医学-临床医学] 10[医学] 

主　　题：liver resection bile leakage wedge total vascular exclusion 

摘      要：BACKGROUND： The primary focus of the study was to ana- lyze the risk factors for bile leakage after hepatectomy for be- nign or malignant tumors. METHODS： A total of 411 patients who had undergone hepa- tectomy between December 2006 and December 2011 were ret- rospectively analyzed. The severity of bile leakage was graded according to the ISGLS classification. Twenty-eight pre- and postoperative parameters were analyzed. RESULTS： The overall bile leakage incidence was 10.2% （42/411）. The severity of the leakage was classified according to the IS- GLS classification. Bile leakage was detected early in case of abdominal drainage （11.4% vs 1.9%, P=0.034）. It prolonged the time of hospitalization （16 vs 9 days, P=0.001）. In all patients, wedge resection was associated with a higher incidence of bile leakage in contrast to anatomical resections （25.6% vs 4.1%, P〈0.0001） regardless of the underlying liver disease. Furthermore, total vascular exclusion increased risk of bile leakage （P=0.008）. CONCLUSIONS： Bile leakage as a major issue after hepatic resection is related to the postoperative morbidity and the hospitalization time. It is associated with non-anatomical re- section and a total vascular exclusion.