Prospective evaluation of the International Study Group for Liver Surgery definition of bile leak after a liver resection and the role of routine operative drainage: an international multicentre study

被引：103

作者：

Brooke-Smith, Mark ^{[1
,2
]}

Figueras, Joan ^{[3
]}

Ullah, Shahid ^{[1
,2
]}

Rees, Myrddin ^{[4
]}

Vauthey, Jean-Nicolas ^{[5
]}

Hugh, Thomas J. ^{[6
]}

Garden, O. James ^{[7
]}

Fan, Sheung Tat ^{[8
]}

Crawford, Michael ^{[9
]}

Makuuchi, Masatoshi ^{[10
]}

Yokoyama, Yukihiro ^{[11
]}

Buechler, Marcus ^{[12
]}

Weitz, Juergen ^{[12
]}

Padbury, Robert ^{[1
,2
]}

机构：

[1] Flinders Med Ctr, Bedford Pk, SA 5065, Australia

[2] Flinders Univ South Australia, Bedford, SA, Australia

[3] Josep Trueta Hosp, Girona, Spain

[4] North Hampshire Hosp, Basingstoke, Hants, England

[5] Univ Texas Houston, MD Anderson Canc Ctr, Houston, TX 77030 USA

[6] Royal N Shore Hosp, Sydney, NSW, Australia

[7] Royal Edinburgh Infirm, Edinburgh, Midlothian, Scotland

[8] Queen Mary Hosp, Hong Kong, Hong Kong, Peoples R China

[9] Royal Prince Alfred Hosp, Sydney, NSW, Australia

[10] Japanese Red Cross Med Ctr, Tokyo, Japan

[11] Nagoya Univ, Grad Sch Med, Nagoya, Aichi 4648601, Japan

[12] Tech Univ Dresden, Dept Surg, D-01062 Dresden, Germany

来源：

HPB | 2015年 / 17卷 / 01期

关键词：

ABDOMINAL DRAINAGE; HEPATIC RESECTION; HEPATECTOMY; MANAGEMENT; COMPLICATIONS; METASTASES; TRIAL;

D O I：

10.1111/hpb.12322

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

BackgroundThe International Study Group for Liver Surgery (ISGLS) proposed a definition for bile leak after liver surgery. A multicentre international prospective study was designed to evaluate this definition. MethodsData collected prospectively from 949 consecutive patients on specific datasheets from 11 international centres were collated centrally. ResultsBile leak occurred in 69 (7.3%) of patients, with 31 (3.3%), 32 (3.4%) and 6 (0.6%) classified as grade A, B and C, respectively. The grading system of severity correlated with the Dindo complication classification system (P < 0.001). Hospital length of stay was increased when bile leak occurred, from a median of 7 to 15 days (P < 0.001), as was intensive care stay (P < 0.001), and both correlated with increased severity grading of bile leak (P < 0.001). 96% of bile leaks occurred in patients with intra-operative drains. Drain placement did not prevent subsequent intervention in the bile leak group with a 5-15 times greater risk of intervention required in this group (P < 0.001). ConclusionThe ISGLS definition of bile leak after liver surgery appears robust and intra-operative drain usage did not prevent the need for subsequent drain placement.

引用

页码：46 / 51

页数：6

共 16 条

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