Kajiwara et al developed a simple score to predict bile leakage after liver resection. This can help to identify a patient who may benefit from more aggressive management. The authors are from Nihon University in Tokyo.
Patient selection: Japanese patient undergoing liver resection
Outcome: bile leakage (bilirubin concentration in drain fluid >= 3 times the serum total bilirubin on or after postoperative day 3)
Parameters:
(1) hepatic resection
(2) indocyanine green clearance at 15 minutes (ICGR15) in percent
(3) serum albumin in g/dL
(4) weight of resected liver
Parameter
Finding
Points
resection
anatomical
0
non-anatomical
2
ICGR15
>= 15%
0
< 15%
1
serum albumin
>= 3.5 g/dL
0
< 3.5 g/dL
1
weight of resected liver
< 70 grams
1
>= 70 grams
0
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 5
• The higher the score the greater the risk of bile leakage.
Total Score
Risk of Bile Leakage
0 or 1
low (5.7%)
2 or 3
moderate (10%)
4 or 5
high (16.6%)
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