Predictive factors for bile leakage after hepatectomy: analysis of 505 consecutive patients.

Abstract

Bile leakage is the most common complication after hepatectomy and its incidence is not declining. The aim of the present study was to identify predictive factors for bile leakage. Clinical data from 505 consecutive patients who underwent hepatectomy without extrahepatic bile duct resection in our department between January 2006 and December 2009 were reviewed retrospectively. The incidence of bile leakage was found to be 6.7%. Multivariate analysis identified three independent factors that were significantly correlated with the occurrence of bile leakage: (1) repeat hepatectomy (P = 0.002; odds ratio [OR] 3.439; 95% confidence interval [CI] 1.552-7.618), (2) a cut surface area ≥57.5 cm(2) (P = 0.004; OR 5.296; 95% CI 1.721-16.302), and (3) intraoperative blood loss ≥775 ml (P = 0.01; OR 2.808; 95% CI 1.280-6.160). More meticulous management is needed to prevent bile leakage in high-risk patients.