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Risk factors for bile leakage: Latest analysis of 10 102 hepatectomies for hepatocellular carcinoma from the Japanese national clinical database
Author(s) -
Yamashita Yoichi,
Yamamoto Hiroyuki,
Miyata Hiroaki,
Kakeji Yoshihiro,
Kitagawa Yuko,
Yamaue Hiroki,
Yamamoto Masakazu,
Baba Hideo
Publication year - 2021
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.827
Subject(s) - medicine , hepatocellular carcinoma , odds ratio , confidence interval , hepatectomy , gastroenterology , database , logistic regression , diabetes mellitus , surgery , resection , endocrinology , computer science
Background/Purpose The aim of this study was to identify risk factors for bile leakage in hepatic resections without biliary reconstructions using the large Japanese national clinical database (NCD). Methods A total of 10 102 patients who had undergone hepatic resection involving more than one segment without biliary reconstructions for hepatocellular carcinoma during 2015‐2017 were enrolled. Risk factors for bile leakage, with special reference to the type of hepatic resection, were identified by multivariable logistic regression analysis. Results Bile leakage occurred in 726 patients (7.2%). Risk factors for bile leakage were as follows: male sex (odds ratio [OR] 1.28, 95% confidence interval [CI] 1.04‐1.58), diabetes mellitus (+) (OR 1.19, 95% CI 1.01‐1.39), hemoglobin <10 g/dL (OR 1.4, 95% CI 1.02‐1.93), albumin <3.5 g/dL (OR 1.3, 95% CI 1.03‐1.63), central bisectionectomy (OR 3.8, 95% CI 2.81‐5.13), left trisectionectomy (OR 3.6, 95% CI 2.10‐6.15), right anterior sectionectomy (OR 2.07, 95% CI 1.58‐2.72), and S5 or S8 segmentectomy (OR 1.33, 95% CI 1.00‐1.77). Conclusion Central bisectionectomy, left trisectionectomy, and right anterior sectionectomy are high‐risk types of hepatic resection for bile leakage.