title: Risk factors for postoperative bile leakage: a retrospective single-center analysis of 411 hepatectomies.
abstract: BACKGROUND
  The primary focus of the study was to analyze the risk factors for bile leakage after hepatectomy for benign or malignant tumors.
  
  
  METHODS
  A total of 411 patients who had undergone hepatectomy between December 2006 and December 2011 were retrospectively analyzed. The severity of bile leakage was graded according to the ISGLS classification. Twenty-eight pre- and postoperative parameters were analyzed.
  
  
  RESULTS
  The overall bile leakage incidence was 10.2% (42/411). The severity of the leakage was classified according to the ISGLS classification. Bile leakage was detected early in case of abdominal drainage (11.4% vs 1.9%, P=0.034). It prolonged the time of hospitalization (16 vs 9 days, P=0.001). In all patients, wedge resection was associated with a higher incidence of bile leakage in contrast to anatomical resections (25.6% vs 4.1%, P<0.0001) regardless of the underlying liver disease. Furthermore, total vascular exclusion increased risk of bile leakage (P=0.008).
  
  
  CONCLUSIONS
  Bile leakage as a major issue after hepatic resection is related to the postoperative morbidity and the hospitalization time. It is associated with non-anatomical resection and a total vascular exclusion.
authors.affiliation: Department of General and Liver Transplant Surgery, Montpellier University Hospital, College of Medicine, 80 Avenue Augustin Fliche 34295, Montpellier-Cedex 5, France. f-panaro@chu-montpellier.fr.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Panaro
authors.forename: Lisa
authors.initials: L
authors.lastname: Hacina
authors.forename: Hassan
authors.initials: H
authors.lastname: Bouyabrine
authors.forename: Al-Warith
authors.initials: AW
authors.lastname: Al-Hashmi
authors.forename: Astrid
authors.initials: A
authors.lastname: Herrero
authors.forename: Francis
authors.initials: F
authors.lastname: Navarro
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057868:Anastomotic Leak / Q000175:diagnosis / Q000453:epidemiology*; D001649:Bile Duct Diseases / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005602:France / Q000453:epidemiology; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult