Independent risk factors that predict bile leakage after hepatectomy for hepatocellular carcinoma: Cohort study. (September 2018)

• Record Type: Journal Article
• Authors: Nakano, Ryosuke; Ohira, Masahiro; Kobayashi, Tsuyoshi; Imaoka, Yuki; Mashima, Hiroaki; Yamaguchi, Megumi; Honmyo, Naruhiko; Okimoto, Sho; Hamaoka, Michinori; Shimizu, Seiichi; Kuroda, Shintaro; Tahara, Hiroyuki; Ide, Kentaro; Ohdan, Hideki
• Is Part Of: International journal of surgery. Volume 57(2018)
• Page Start: 1
• Page End: 7
• Publication Date: 2018-09
• Subjects: Postoperative bile leakage -- Stereotactic body radiotherapy -- Hepatectomy -- Hepatocellular carcinoma; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; 617.005
• DOI: 10.1016/j.ijsu.2018.07.005
• Languages: English
• ISSNs: 1743-9191

Abstract

Abstract: Background: Bile leakage is a major cause of morbidity after hepatectomy. This study aimed to identify the predictive factors for bile leakage after hepatectomy. Materials and methods: Between January 2011 and December 2016, 556 patients underwent a liver resection for hepatocellular carcinoma with curative intent, and were enrolled to participate in this study. The incidence of postoperative bile leakage (POBL) was determined and the predictive factors for POBL were identified using univariate and multivariate analysis. Results: POBLs occurred in 28 patients (5.0%). The multivariate analysis identified a history of stereotactic body radiotherapy, a body mass index <20 kg/m 2, Child-Pugh class B cirrhosis, a central hepatectomy, and an operation time ≥375 min as risk factors that were associated with POBL. When the study cohort was grouped according to the number of the predictive factors present, the incidence of POBL increased as the number of the extant independent predictive factors increased. The POBL rate was 45.0% in patients with ≥3 predictive factors. Conclusion: We determined that POBL was associated with operative mortality and identified five independent predictive factors associated with POBL. Risk stratification using these predictive factors may be useful for identifying patients at a high risk of POBL. Highlights: Postoperative bile leakage (POBL) is associated with operative mortality. Risk factors for POBL were history of SBRT, low body mass index, Child-Pugh B, central hepatectomy, and long operation time. Risk stratification with these factors may identify patients at a high POBL risk.