Bile Leakage After Hepatic Resection for Hepatocellular Carcinoma: Does It Impact the Short- and Long-term Outcomes?
Bile leakage
Hepatic resection
Hepatocellular carcinoma
Survival
Journal
Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
ISSN: 1873-4626
Titre abrégé: J Gastrointest Surg
Pays: United States
ID NLM: 9706084
Informations de publication
Date de publication:
10 2022
10 2022
Historique:
received:
01
05
2022
accepted:
29
07
2022
pubmed:
25
8
2022
medline:
19
10
2022
entrez:
24
8
2022
Statut:
ppublish
Résumé
Bile leakage (BL) is one of the commonest morbidities after hepatic resection for hepatocellular carcinoma (HCC). The current study was conducted to evaluate the incidence and different predictive factors for BL after hepatic resection for HCC, and to evaluate of the impact of BL on the long-term survival outcomes. We reviewed the patients' data who underwent hepatic resection for HCC during the period between June 2010 and June 2019. A total of 293 patients were included in the study. BL occurred in 17 patients (5.8%). More Child-Pugh class B patients were found in BL group. There were no significant differences between the two groups except for tumor site, macroscopic portal vein invasion, extent of liver resection, Pringle maneuver use, intraoperative blood loss, and transfusions. Longer hospital stay, higher grades of post-hepatectomy liver failure, and abdominal collections were noted in BL group. After median follow-up duration of 17 months (4-110 months), there were no significant differences between BL and non-BL group regarding overall survival (log-rank, p = 0.746) and disease-free survival (log-rank, p = 0.348). In multivariate analysis, Child-Pugh class, macroscopic portal vein invasion, liver resection extent (minor/major), and Pringle's maneuver use were the only significant predictors of BL. BL did not significantly impair the long-term outcomes after hepatic resection for HCC. Child-Pugh class, macroscopic portal vein invasion, liver resection extent (minor/major), and Pringle's maneuver use were the main risk factors of BL in the current study.
Sections du résumé
BACKGROUND
Bile leakage (BL) is one of the commonest morbidities after hepatic resection for hepatocellular carcinoma (HCC). The current study was conducted to evaluate the incidence and different predictive factors for BL after hepatic resection for HCC, and to evaluate of the impact of BL on the long-term survival outcomes.
METHODS
We reviewed the patients' data who underwent hepatic resection for HCC during the period between June 2010 and June 2019.
RESULTS
A total of 293 patients were included in the study. BL occurred in 17 patients (5.8%). More Child-Pugh class B patients were found in BL group. There were no significant differences between the two groups except for tumor site, macroscopic portal vein invasion, extent of liver resection, Pringle maneuver use, intraoperative blood loss, and transfusions. Longer hospital stay, higher grades of post-hepatectomy liver failure, and abdominal collections were noted in BL group. After median follow-up duration of 17 months (4-110 months), there were no significant differences between BL and non-BL group regarding overall survival (log-rank, p = 0.746) and disease-free survival (log-rank, p = 0.348). In multivariate analysis, Child-Pugh class, macroscopic portal vein invasion, liver resection extent (minor/major), and Pringle's maneuver use were the only significant predictors of BL.
CONCLUSION
BL did not significantly impair the long-term outcomes after hepatic resection for HCC. Child-Pugh class, macroscopic portal vein invasion, liver resection extent (minor/major), and Pringle's maneuver use were the main risk factors of BL in the current study.
Identifiants
pubmed: 36002785
doi: 10.1007/s11605-022-05433-7
pii: 10.1007/s11605-022-05433-7
pmc: PMC9568438
doi:
Types de publication
Journal Article
Review
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2070-2081Informations de copyright
© 2022. The Author(s).
Références
Surgery. 2011 May;149(5):680-8
pubmed: 21316725
Arch Surg. 1998 Feb;133(2):156-61
pubmed: 9484727
Arch Surg. 2003 Nov;138(11):1198-206; discussion 1206
pubmed: 14609867
J Surg Res. 2021 Oct;266:269-283
pubmed: 34038849
Eur J Surg Oncol. 2019 Jun;45(6):1077-1083
pubmed: 30803908
ANZ J Surg. 2017 Jul;87(7-8):E26-E31
pubmed: 25880020
Br J Anaesth. 1996 Aug;77(2):217-22
pubmed: 8881629
Ann Surg. 2004 Aug;240(2):205-13
pubmed: 15273542
Am J Surg. 2003 Apr;185(4):316-8
pubmed: 12657381
J Am Coll Surg. 2007 Jun;204(6):1284-92
pubmed: 17544086
Ann Surg. 2001 Jan;233(1):45-50
pubmed: 11141224
Br J Surg. 2001 Jul;88(7):969-74
pubmed: 11442529
Arch Surg. 1999 Sep;134(9):984-92
pubmed: 10487594
Dig Surg. 2007;24(4):294-9
pubmed: 17657155
Langenbecks Arch Surg. 2021 Feb;406(1):87-98
pubmed: 32778915
J Am Coll Surg. 2002 Oct;195(4):484-9
pubmed: 12375753
World J Surg. 2003 Jun;27(6):695-8
pubmed: 12732991
Arch Surg. 2006 Jul;141(7):690-4; discussion 695
pubmed: 16847242
J Hepatobiliary Pancreat Sci. 2020 Dec;27(12):931-941
pubmed: 32359192
J Hepatobiliary Pancreat Sci. 2010 Sep;17(5):709-18
pubmed: 20703850
Surgery. 2011 May;149(5):713-24
pubmed: 21236455
Hepatogastroenterology. 2013 Oct;60(127):1717-9
pubmed: 24634941
Ann Surg. 2002 Oct;236(4):397-406; discussion 406-7
pubmed: 12368667
Eurasian J Med. 2014 Feb;46(1):36-41
pubmed: 25610292