Nagano et al classified bile leakage following hepatic resection. The type of leakage may influence patient management. The authors are from Yokohama City University in Japan.
Patient selection: bile leakage following hepatic resection
Findings
Type
no bile duct involvement on imaging studies
A
leakage from stump of a main bile duct
B
leakage from the side of a main bile duct
C
leakage from peripheral bile ducts supplying an isolated hepatic segment, without communication to the main biliary tree
D
Type A is considered minor while the others are major.
Type
Management
A
tend to heal with fastest resolution
B
may benefit from nasobiliary tube drainage
C
may benefit from nasobiliary tube drainage
D
usually require reoperation
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