Display Settings:

Format

Send to:

Choose Destination
See comment in PubMed Commons below
Arch Surg. 2006 Jul;141(7):690-4; discussion 695.

Bile leakage and liver resection: Where is the risk?

Author information

  • 1Unit of Surgical Oncology, Institute for Cancer Research and Treatment, Candiolo, Italy. lcapussotti@mauriziano.it

Abstract

HYPOTHESIS:

The knowledge of risk factors for bile leakage after liver resection could reduce its incidence.

DESIGN:

Retrospective study.

SETTING:

Tertiary care referral center.

PATIENTS:

The study included 610 patients who underwent liver resection from January 1, 1989, through January 31, 2003.

INTERVENTIONS:

Liver resections without biliary anastomoses.

MAIN OUTCOME MEASURES:

Bile leakage incidence and its correlation to preoperative and intraoperative patient characteristics.

RESULTS:

Postoperative bile leakage occurred in 22 (3.6%) of 610 patients. Univariate analysis showed that cirrhosis (P = .05) or intraoperative use of fibrin glue (P = .01) was associated with a lower incidence of bile leakage. Moreover, the following factors were significant predictors of bile leakage: peripheral cholangiocarcinoma (P < .001), major hepatectomy (P = .03), left hepatectomy extended to segment 1 (P < .001), extension of transection out of the main portal scissure (P = .006), and hepatectomy including segment 1 (P = .001) or segment 4 (P = .003). At multivariate analysis, use of fibrin glue was an independent protective factor (relative risk = 0.38, P = .046), whereas peripheral cholangiocarcinoma (relative risk = 5.47, P = .02) and resection of segment 4 (relative risk = 3.10, P = .02) were independent risk factors for bile leakage.

CONCLUSIONS:

Hepatectomies including segment 4, especially if performed for peripheral cholangiocarcinoma, lead to a high risk for postoperative bile leakage. Intraoperative use of fibrin glue may reduce the risk of postoperative bile leakage.

PMID:
16847242
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Icon for Silverchair Information Systems
    Loading ...
    Write to the Help Desk