title: Regeneration of Liver Function Capacity After Partial Liver Resection is Impaired in Case of Postoperative Bile Leakage.
abstract: Postoperative bile leakage (PBL) is a major surgical complication after partial liver resection resulting in increased perioperative morbidity and mortality. Previous experimental studies have shown an adverse effect on functional liver regeneration, but there are still no data available concerning these effects in humans.
  
  
  
  A retrospective matched pair analysis was carried out comparing the postoperative course of 51 patients with PBL to 51 patients without PBL. The influence of PBL on actual liver function was determined by means of LiMAx, Indocyanine green plasma disappearance rate (ICG-PDR), and standard liver function tests.
  
  
  
  The analyzed groups were matched regarding demographic, preoperative, and operative data. Bilirubin, ICG-PDR and LiMAx showed delayed postoperative functional recovery after partial liver resection in the PBL group compared to the non-PBL group. LiMAx was the single parameter to assess differing liver regeneration continuously from the 3rd to 14th postoperative day between the groups. A subanalysis revealed an early recovery from impaired functional regeneration if the bile leakage was diagnosed until the 5th postoperative day (POD) or successfully treated until the 14th POD.
  
  
  
  These are the first data evaluating the impact of PBL on functional regeneration after liver surgery. Liver regeneration after partial liver resection is impaired by PBL. However, a nearly normal recovery is possible if the bile leak is diagnosed early and immediately treated. Moreover, patients presenting with delayed functional recovery in the postoperative course are likely to have complications, e.g., bile leakage.
authors.affiliation: Department of General, Visceral and Transplantation Surgery, Charité - Universitätsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.|Department of General, Visceral and Transplantation Surgery, University Clinic Aachen, Rhine Westphalia Institute of Technology, Aachen, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Bednarsch
authors.affiliation: Department of General, Visceral and Transplantation Surgery, Charité - Universitätsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Blüthner
authors.affiliation: Department of General, Visceral and Transplantation Surgery, Charité - Universitätsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.|Department of General, Visceral, Vascular and Pediatric Surgery, University of Saarland, Homburg, Germany.
authors.forename: Maciej
authors.initials: M
authors.lastname: Malinowski
authors.affiliation: Department of General, Visceral and Transplantation Surgery, Charité - Universitätsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Seehofer
authors.affiliation: Department of General, Visceral and Transplantation Surgery, Charité - Universitätsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.
authors.forename: Johann
authors.initials: J
authors.lastname: Pratschke
authors.affiliation: Department of General, Visceral and Transplantation Surgery, Charité - Universitätsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany. martin.stockmann@charite.de.
authors.forename: Martin
authors.initials: M
authors.lastname: Stockmann
mesh_terms: D001646:Bile; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008111:Liver Function Tests; D008115:Liver Regeneration; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies