Risk Factors of Yamashita et al for Bile Leakage After Hepatic Resection

The authors are from Kyushu University in Fukuoka, Japan.

Patient selection: hepatic resection

Bile leakage was defined as drainage of macroscopic bile from the surgical drains >= 7 days after surgery.

The primary risk factor from multivariate analysis was a high-risk procedure, defined as one where the cut surface is exposed the major Glisson’s sheath and included the hepatic hilum. Examples are:

(1) anterior segmentectomy

(2) central bisegmentectomy

(3) total caudate lobectomy.

Additional factors from univariate analysis:

(1) intraoperative bleeding >= 2,000 grams

(2) surgical time > 300 minutes

Intractable bile leakage can lead to uncontrollable ascites and/or bile peritonitis.