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The incidence and severity of post-hepatectomy bile leaks is affected by surgical indications,preoperative chemotherapy,and surgical procedures

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Hepatobiliary Surgery and Nutrition 2019年第2期8卷 101-110页

作者： Vinzent N.Spetzler marlene schepers Hans O.Pinnschmidt Lutz Fischer Bj?rn Nashan Jun Li Department of Hepatobiliary Surgery and Visceral Transplantation University Medical Center Hamburg-EppendorfHamburgGermany Department of Medical Biometry and Epidemiology University Medical Center Hamburg-EppendorfHamburgGermany

Background:Bile leaks are one of the most common complications after liver *** International Study Group of Liver Surgery(ISGLS)established a uniform bile leak definition including a severity ***,a risk factor assessment according to ISGLS grading as well as the clinical implications has not been studied sufficiently so ***:The incidence and grading of bile leaks according to ISGLS were prospectively documented in 501 consecutive liver resections between July 2012 and December 2016.A multivariate regression analysis was performed for risk factor *** with other surgical complications,90-day mortality as well as length of hospital stay(LOS)was ***:The total rate of bile leaks in this cohort was 14.0%:2.8%grade A,8.0%grade B,and 3.2%grade C bile leaks were *** chemotherapy or biliary intervention,diagnosis of hilar cholangiocarcinoma,colorectal metastasis,central minor liver resection,major hepatectomy,extended hepatectomy or two-stage hepatectomy,were some of the risk factors leading to bile *** multivariate regression analysis revealed that preoperative chemotherapy,major hepatectomy and biliodigestive reconstruction remained significant independent risk factors for bile *** C bile leaks were associated not only with surgical site infection,but also with an increased 90-day mortality and prolonged ***:The preoperative treatment as well as the surgical procedure had significant influence on the incidence and the severity of bile *** C bile leaks were clinically most relevant,and led to significant increased LOS,rate of infection,and mortality.

关键词： Bile leakage post-operative complication liver resection International Study Group of Liver Surgery(ISGLS) Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy(ALPPS)

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