Risk factors - general patient factors:
(1) advanced age
(2) poor general health
Risk factors - stricture:
(1) proximal stricture of the extrahepatic bile ducts (Bismuth Type 3 or Type 4)
(2) intrahepatic strictures
(3) multiple strictures
Risk factors - surgical:
(1) multiple previous attempts at repair
(2) surgeon inexperience
(3) end-to-end biliary anastomosis
Risk factors - liver disease:
(1) portal hypertension
(2) hepatic lobar atrophy
(3) intrahepatic lithiasis
(4) hepatic cirrhosis, fibrosis or other hepatic parenchymal disease
Risk factors - abnormal bile drainage:
(1) intra-abdominal bile collection (implies leakage)
(2) internal or external biliary fistula
Risk factors - infection:
(1) acute cholangitis
(2) intra-hepatic abscess
(3) intra-abdominal abscess
