title: Predictive factors for bile leakage after hepatectomy: analysis of 505 consecutive patients.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  More meticulous management is needed to prevent bile leakage in high-risk patients.
authors.affiliation: Department of Gastrointestinal Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo 135-8500, Japan.
authors.forename: Ryuji
authors.initials: R
authors.lastname: Yoshioka
authors.forename: Akio
authors.initials: A
authors.lastname: Saiura
authors.forename: Rintaro
authors.initials: R
authors.lastname: Koga
authors.forename: Makoto
authors.initials: M
authors.lastname: Seki
authors.forename: Yoji
authors.initials: Y
authors.lastname: Kishi
authors.forename: Junji
authors.initials: J
authors.lastname: Yamamoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001646:Bile; D001650:Bile Duct Neoplasms / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D018281:Cholangiocarcinoma / Q000601:surgery*; D015179:Colorectal Neoplasms / Q000601:surgery*; D003430:Cross-Sectional Studies; D005260:Female; D005706:Gallbladder Neoplasms / Q000601:surgery*; D006498:Hepatectomy / Q000009:adverse effects* / Q000379:methods; D049669:History, 16th Century; D049670:History, 17th Century; D049671:History, 18th Century; D006801:Humans; D008107:Liver Diseases / Q000453:epidemiology* / Q000209:etiology*; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors