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  • Title: Incidence and management of bile leakage after partial liver resection.
    Author: Erdogan D, Busch OR, van Delden OM, Rauws EA, Gouma DJ, van Gulik TM.
    Journal: Dig Surg; 2008; 25(1):60-6. PubMed ID: 18292662.
    Abstract:
    BACKGROUND/AIMS: Bile leakage after partial liver resection still is a common complication and is associated with substantial morbidity and even mortality. METHODS: A total of 234 consecutive liver resections without biliary reconstruction, performed between January 1992 and December 2004, were analyzed for postoperative bile leakage. RESULTS: Postoperative bile leakage occurred in 6.8% of patients (16/234). In univariate analysis, male gender (p = 0.037), major liver resection (p = 0.004), right-sided hepatectomy (p = 0.005), prolonged operation time (p = 0.001), intraoperative blood loss >500 ml (p = 0.009), red cell transfusion (p = 0.02), tumor size (p = 0.026), duration of vascular occlusion (p = 0.03) and surgical irradicality (p = 0.001) were risk factors. No independent risk factors were associated with bile leakage after liver resection. Bile leakage originated from the resection plane in 10 patients (63%). Endoscopic biliary decompression was performed in 9 patients as initial treatment, and percutaneous drainage of the bile collection was used in 4 patients. Bile leakage resolved spontaneously in 3 patients. CONCLUSIONS: Bile leakage is a persisting complication and in this study occurred in 6.8% of patients after partial liver resection. Percutaneous drainage of bile collection with or without endoscopic biliary decompression are effective interventions in the management of most cases of bile leakage.
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