title: Incidence and management of bile leakage after partial liver resection.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: D
authors.initials: D
authors.lastname: Erdogan
authors.forename: O R C
authors.initials: OR
authors.lastname: Busch
authors.forename: O M
authors.initials: OM
authors.lastname: van Delden
authors.forename: E A J
authors.initials: EA
authors.lastname: Rauws
authors.forename: D J
authors.initials: DJ
authors.lastname: Gouma
authors.forename: T M
authors.initials: TM
authors.lastname: van Gulik
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001646:Bile; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008107:Liver Diseases / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000628:therapy; D012307:Risk Factors