title: Risk factors of bile leakage after hepatectomy for hepatocellular carcinoma.
abstract: OBJECTIVE
  To identify the risk factors for postoperative biliary complications after hepatic resection for hepatocellular carcinoma.
  
  
  METHODS
  The subjects were 123 patients who underwent hepatic resection for hepatocellular carcinoma between January 2006 and December 2010. Perioperative factors related to postoperative bile leakage were studied.
  
  
  RESULTS
  Postoperative bile leakage occurred in eight (6.5%) of the patients. Univariate analysis showed that liver fibrosis or cirrhosis (p=0.007), long operation time (>5 hours) (p=0.002), major hepatic resection (p=0.024) and hepatectomy including Couinaud's segment 4 (p=0.0078) or segment 5 (p=0.023) were associated with an incidence of bile leakage. From multivariate analysis, operation time (relative risk=6.10, p=0.026) or resection of segment 4 (relative risk=6.86, p=0.017) were found to be independent risk factors for bile leakage.
  
  
  CONCLUSIONS
  Prolonged operation time and hepatectomy including segment 4 led to a high risk for postoperative bile leakage in this series of patients.
authors.forename: Kenji
authors.initials: K
authors.lastname: Okumura
authors.forename: Keishi
authors.initials: K
authors.lastname: Sugimachi
authors.forename: Nao
authors.initials: N
authors.lastname: Kinjo
authors.forename: Fumihiro
authors.initials: F
authors.lastname: Shoji
authors.forename: Masahiko
authors.initials: M
authors.lastname: Ikebe
authors.forename: Ichiro
authors.initials: I
authors.lastname: Makino
authors.forename: Hidefumi
authors.initials: H
authors.lastname: Higashi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057868:Anastomotic Leak / Q000209:etiology*; D001660:Biliary Tract Diseases / Q000209:etiology*; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery*; D016009:Chi-Square Distribution; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome