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. Issue 1 (January 2015)

• Record Type: Journal Article
• Authors: Brooke-Smith, Mark; Figueras, Joan; Ullah, Shahid; Rees, Myrddin; Vauthey, Jean-Nicolas; Hugh, Thomas J.; Garden, O. James; Fan, Sheung Tat; Crawford, Michael; Makuuchi, Masatoshi; Yokoyama, Yukihiro; Büchler, Marcus; Weitz, Juergen; Padbury, Robert
• Is Part Of: HPB. Volume 17:Issue 1(2015:Jan.)
• Page Start: 46
• Page End: 51
• Publication Date: 2015-01
• Subjects: Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 616.362005
• DOI: 10.1111/hpb.12322
• Languages: English
• ISSNs: 1365-182X

Abstract

Abstract: Background: The 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. Methods: Data collected prospectively from 949 consecutive patients on specific datasheets from 11 international centres were collated centrally. Results: Bile 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). Conclusion: The ISGLS definition of bile leak after liver surgery appears robust and intra-operative drain usage did not prevent the need for subsequent drain placement.