Does the placement of a cystic duct tube after a hepatic resection help reduce the incidence of post‐operative bile leak?. Issue 7 (19th November 2012)

• Record Type: Journal Article
• Authors: Nanashima, Atsushi; Abo, Takafumi; Shibuya, Ayako; Tominaga, Tetsuro; Matsumoto, Aya; Tou, Kazuo; Kunizaki, Masaki; Takeshita, Hiroaki; Hidaka, Shigekazu; Tsuchiya, Tomoshi; Yamasaki, Naoya; Nagayasu, Takeshi
• Is Part Of: HPB. Volume 15:Issue 7(2013:Jul.)
• Page Start: 517
• Page End: 522
• Publication Date: 2012-11-19
• Subjects: Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 616.362005
• DOI: 10.1111/j.1477-2574.2012.00611.x
• Languages: English
• ISSNs: 1365-182X

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="hpb611-sec-0001" sec-type="section"> <title>Background</title> <p>In this retrospective study, the effects of cystic duct (C) tube use on the incidence of post‐hepatectomy bile leak were assessed.</p> </sec> <sec id="hpb611-sec-0002" sec-type="section"> <title>Methods</title> <p>The subjects were 550 patients who underwent a hepatectomy during 1990–2011, with (<italic>n</italic> = 83) and without (<italic>n</italic> = 467) C tube drainage. The use of a C tube was based on the surgeon's choice.</p> </sec> <sec id="hpb611-sec-0003" sec-type="section"> <title>Results</title> <p>Bile leakage was observed in 44 (8%) patients, and its incidence post‐operatively correlated with intrahepatic cholangiocarcinoma, parenchymal transection with forceps fracture and tie, a major hepatectomy, prolonged surgery and excessive blood loss (<italic>P</italic> < 0.050) but not with the use of a C tube. The incidence of an intra‐abdominal infection was higher and the hospital stay was longer in the leak (49 days) than non‐leak group (21 days, <italic>P</italic> < 0.001). ISGLS grade B and C bile leak post‐hemi‐hepatectomy and extended‐hepatectomy were more frequent in the non‐C than C tube group (<italic>P</italic> = 0.016). The duration of hospitalization was not different between the two groups; however, 7 patients in the non‐C tube group had prolonged hospitalization (> 60 days) compared with none in the C tube group (<italic>P</italic> = 0.454).</p> </sec> <sec id="hpb611-sec-0004" sec-type="section"> <title>Conclusion</title> <p>The usefulness of the C tube in preventing post‐hepatectomy bile leak could not be confirmed; however, both bile leak requiring clinical management and long hospitalization after a major hepatectomy could be reduced with C tube use.</p> </sec> </abstract>