Predictive Factors for Bile Leakage After Hepatectomy: Analysis of 505 Consecutive Patients

被引:47
作者
Yoshioka, Ryuji [1 ]
Saiura, Akio [1 ]
Koga, Rintaro [1 ]
Seki, Makoto [1 ]
Kishi, Yoji [1 ]
Yamamoto, Junji [2 ]
机构
[1] Japanese Fdn Canc Res, Canc Inst Hosp, Dept Gastrointestinal Surg, Koto Ku, Tokyo 1358500, Japan
[2] Natl Def Med Coll Hosp, Dept Hepatobiliarypancreat Surg, Saitama, Japan
基金
日本学术振兴会;
关键词
ELECTIVE HEPATIC RESECTION; SURGICAL COMPLICATIONS; ABDOMINAL DRAINAGE; LIVER RESECTION; MANAGEMENT; CLASSIFICATION; TRIAL;
D O I
10.1007/s00268-011-1114-7
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background Bile leakage is the most common complication after hepatectomy and its incidence is not declining. The aim of the present study was to identify predictive factors for bile leakage. Methods Clinical data from 505 consecutive patients who underwent hepatectomy without extrahepatic bile duct resection in our department between January 2006 and December 2009 were reviewed retrospectively. Results The incidence of bile leakage was found to be 6.7%. Multivariate analysis identified three independent factors that were significantly correlated with the occurrence of bile leakage: (1) repeat hepatectomy (P = 0.002; odds ratio [OR] 3.439; 95% confidence interval [CI] 1.552-7.618), (2) a cut surface area >= 57.5 cm(2) (P = 0.004; OR 5.296; 95% CI 1.721-16.302), and (3) intraoperative blood loss >= 775 ml (P = 0.01; OR 2.808; 95% CI 1.280-6.160). Conclusion More meticulous management is needed to prevent bile leakage in high-risk patients.
引用
收藏
页码:1898 / 1903
页数:6
相关论文
共 26 条
[1]   Postoperative pancreatic fistula: An international study group (ISGPF) definition [J].
Bassi, C ;
Dervenis, C ;
Butturini, G ;
Fingerhut, A ;
Yeo, C ;
Izbicki, J ;
Neoptolemos, J ;
Sarr, M ;
Traverso, W ;
Buchler, M .
SURGERY, 2005, 138 (01) :8-13
[2]   DRAINAGE AFTER ELECTIVE HEPATIC RESECTION - A RANDOMIZED TRIAL [J].
BELGHITI, J ;
KABBEJ, M ;
SAUVANET, A ;
VILGRAIN, V ;
PANIS, Y ;
FEKETE, F .
ANNALS OF SURGERY, 1993, 218 (06) :748-753
[3]   Bile leakage and liver resection -: Where is the risk? [J].
Capussotti, Lorenzo ;
Ferrero, Alessandro ;
Vigano, Luca ;
Sgotto, Enrico ;
Muratore, Andrea ;
Polastri, Roberto .
ARCHIVES OF SURGERY, 2006, 141 (07) :690-694
[4]   The Clavien-Dindo Classification of Surgical Complications Five-Year Experience [J].
Clavien, Pierre A. ;
Barkun, Jeffrey ;
de Oliveira, Michelle L. ;
Vauthey, Jean Nicolas ;
Dindo, Daniel ;
Schulick, Richard D. ;
de Santibanes, Eduardo ;
Pekolj, Juan ;
Slankamenac, Ksenija ;
Bassi, Claudio ;
Graf, Rolf ;
Vonlanthen, Rene ;
Padbury, Robert ;
Cameron, John L. ;
Makuuchi, Masatoshi .
ANNALS OF SURGERY, 2009, 250 (02) :187-196
[5]   Classification of surgical complications - A new proposal with evaluation in a cohort of 6336 patients and results of a survey [J].
Dindo, D ;
Demartines, N ;
Clavien, PA .
ANNALS OF SURGERY, 2004, 240 (02) :205-213
[6]   Incidence and management of bile leakage after partial liver resection [J].
Erdogan, D. ;
Busch, O. R. C. ;
Van Delden, O. M. ;
Rauws, E. A. J. ;
Gouma, D. J. ;
Van Gulik, T. M. .
DIGESTIVE SURGERY, 2008, 25 (01) :60-66
[7]   Effect of type of resection on outcome of hepatic resection for colorectal metastases [J].
Finch, R. J. B. ;
Malik, H. Z. ;
Hamady, Z. Z. R. ;
Al-Mukhtar, A. ;
Adair, R. ;
Prasad, K. R. ;
Lodge, J. P. A. ;
Toogood, G. J. .
BRITISH JOURNAL OF SURGERY, 2007, 94 (10) :1242-1248
[8]   Drainage is unnecessary after elective liver resection [J].
Fong, Y ;
Brennan, MF ;
Brown, K ;
Heffernan, N ;
Blumgart, LH .
AMERICAN JOURNAL OF SURGERY, 1996, 171 (01) :158-162
[9]   Randomized trial of the usefulness of a bile leakage test during hepatic resection [J].
Ijichi, M ;
Takayama, T ;
Toyoda, H ;
Sano, K ;
Kubota, K ;
Makuuchi, M .
ARCHIVES OF SURGERY, 2000, 135 (12) :1395-1400
[10]   One thousand fifty-six hepatectomies without mortality in 8 years [J].
Imamura, H ;
Seyama, Y ;
Kokudo, N ;
Maema, A ;
Sugawara, Y ;
Sano, K ;
Takayama, T ;
Makuuchi, M .
ARCHIVES OF SURGERY, 2003, 138 (11) :1198-1206