title: Postoperative peripheral blood monocyte count correlates with postoperative bile leakage in patients with colorectal liver metastases after hepatic resection.
abstract: OBJECTIVE
  Postoperative bile leakage is one of the most common complications after hepatic surgery. The relationship between the inflammatory response and postoperative bile leakage has not been fully investigated. Therefore, we retrospectively investigated the relation between postoperative peripheral blood monocyte count and bile leakage in patients with colorectal liver metastases (CRLM) after elective hepatic resection.
  
  
  METHODS
  The study comprised 105 patients who had undergone hepatic resection for CRLM between January 2000 and March 2012. Perioperative risk factors pertinent to development of bile leakage were investigated using univariate and multivariate analyses.
  
  
  RESULTS
  Bile leakage developed in 9 (8.6 %) of 105 patients. In multivariate analysis, intraoperative fresh frozen plasma (FFP) transfusion (p = 0.009) and lower monocyte count of the peripheral blood on postoperative day 1 (p = 0.038) were found as independent risk factors of bile leakage.
  
  
  CONCLUSIONS
  Postoperative lower monocyte count and intraoperative FFP transfusion were associated with the development of postoperative bile leakage after elective hepatic resection in patients with CRLM.
authors: Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo 105-8461, Japan. haruki@jikei.ac.jp
authors: Koichiro
authors: K
authors: Haruki
authors: Hiroaki
authors: H
authors: Shiba
authors: Yuki
authors: Y
authors: Fujiwara
authors: Kenei
authors: K
authors: Furukawa
authors: Shigeki
authors: S
authors: Wakiyama
authors: Masaichi
authors: M
authors: Ogawa
authors: Yuichi
authors: Y
authors: Ishida
authors: Takeyuki
authors: T
authors: Misawa
authors: Katsuhiko
authors: K
authors: Yanaga
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods; D057868:Anastomotic Leak / Q000097:blood* / Q000175:diagnosis; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001652:Bile Ducts / Q000601:surgery; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000601:surgery; D017558:Elective Surgical Procedures / Q000009:adverse effects / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D007958:Leukocyte Count; D007963:Leukocytes, Mononuclear; D008113:Liver Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020360:Neoadjuvant Therapy; D010949:Plasma; D011182:Postoperative Care / Q000379:methods; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents
references: J Hepatobiliary Pancreat Surg. 2005;12(5):351-5
references: 16258801
references: Hepatology. 2012 Jan;55(1):209-21
references: 21932404
references: Ann Surg. 2004 Oct;240(4):698-708; discussion 708-10
references: 15383797
references: Eur J Gastroenterol Hepatol. 2008 Sep;20(9):837-42
references: 18794596
references: Ann Surg. 2001 Jan;233(1):45-50
references: 11141224
references: Liver. 2002 Dec;22(6):486-94
references: 12445174
references: J Surg Oncol. 2011 Feb;103(2):140-7
references: 21259247
references: Science. 1996 Nov 22;274(5291):1379-83
references: 8910279
references: Langenbecks Arch Surg. 2007 May;392(3):273-84
references: 17380346
references: J Invest Surg. 2013 Feb;26(1):36-45
references: 23390996
references: Arch Surg. 1998 Feb;133(2):156-61
references: 9484727
references: Br J Cancer. 2006 Apr 10;94(7):982-99
references: 16538219
references: Arch Surg. 2003 Nov;138(11):1198-206; discussion 1206
references: 14609867
references: Ann Surg. 1999 Sep;230(3):309-18; discussion 318-21
references: 10493478
references: Am J Surg. 1995 Jun;169(6):589-94
references: 7771622
references: J Surg Oncol. 2012 Jul 1;106(1):31-5
references: 22231029
references: J Surg Res. 2011 Jan;165(1):59-67
references: 20031174
references: World J Surg. 2003 Jun;27(6):695-8
references: 12732991
references: Ann Surg. 2007 Nov;246(5):806-14
references: 17968173
references: Arch Surg. 2006 Jul;141(7):690-4; discussion 695
references: 16847242
references: Scand J Immunol. 2009 Aug;70(2):101-5
references: 19630915
references: Ann Surg. 2002 Oct;236(4):397-406; discussion 406-7
references: 12368667
references: Surgery. 2008 Jun;143(6):790-802
references: 18549896