Premium
Impact of postoperative bile leakage on long‐term outcome in patients following liver resection for hepatocellular carcinoma
Author(s) -
Yamamoto Masateru,
Kobayashi Tsuyoshi,
Kuroda Shintaro,
Hamaoka Michinori,
Honmyo Naruhiko,
Yamaguchi Megumi,
Takei Daisuke,
Ohdan Hideki
Publication year - 2020
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1002/jhbp.750
Subject(s) - hepatocellular carcinoma , medicine , hazard ratio , hepatectomy , gastroenterology , resection , surgery , confidence interval
Background/Purpose The incidence of bile leakage after liver resection for hepatocellular carcinoma (HCC) remains a cause for concern. There are limited reports on the impacts of postoperative bile leakage on long‐term clinical outcomes. This study aims to evaluate the effects of postoperative bile leakage on recurrence‐free survival (RFS) and overall survival (OS). Methods A total of 1,178 patients who underwent curative liver resection for HCC between 1986 and 2012 were included in the present study. Postoperative bile leakage was defined using the International Study Group of Liver Surgery definition, and the primary end points of the study were OS and RFS at 5 years. Results Forty‐three (3.7%) patients had bile leakage following liver resection. The median follow‐up was 5 years. A follow‐up analysis revealed that patients with bile leakage had poor 5‐year rates of OS (41.0% vs 56.4%, P = .013) and RFS (14.6% vs 28.7%, P < .001). Additionally, bile leakage was an independent factor for both OS [hazard ratio (HR) 1.559, P = .022] and RFS (HR 1.517, P = .024). Furthermore, bile leakage was the only factor affecting prognosis among postoperative complications. Conclusions Postoperative bile leakage worsens long‐term clinical outcomes following liver resection in HCC patients.