Risk Factors of Lo et al for Biliary Complication After Hepatic Resection

Patient selection: hepatic resection (66% major with resection of >= 3 liver segments; 82% for malignancy)

Outcome: bile leak (one or more of: draining bile from abdominal wound or drain; intra-abdominal collection of bile; cholangiographic evidence of bile leak) or stricture

Risk factors for biliary complications by stepwise logistic regression:

(1) older age (60 years  +/- 2.5 with complications; 53 +/- 0.8 without)

(2) higher preoperative white blood cell count

(3) left-sided hepatectomy, especially with major resection

(4) prolonged operation time (450 +/- 38 with complications; 327 +/- 7 without)

The risk for the left-sided hepatectomy could be reduced by preoperative cholangiography to detect bile duct anomalies.

Risk factor for poor prognosis:

(1) major bile leak (from common bile duct or its bifurcation)