Risk factors for postoperative bile leak in patients who underwent subtotal cholecystectomy View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2019-12-09

AUTHORS

Atsushi Kohga, Kenji Suzuki, Takuya Okumura, Kimihiro Yamashita, Jun Isogaki, Akihiro Kawabe, Taizo Kimura

ABSTRACT

BackgroundSubtotal cholecystectomy (SC) is a procedure for avoiding the risk of bile duct injury, especially in patients with difficult gallbladders. However, recent meta-analyses have demonstrated that SC is associated with a relatively high incidence of postoperative bile leak. To our knowledge, there have been no reports that have investigated risk factors for postoperative bile leak.MethodsA total of 76 patients underwent reconstituting SC at our hospital between January 2005 and July 2019. Patient characteristics and perioperative outcomes were reviewed, and risk factors for postoperative bile leak were investigated. In addition, in patients with acute cholecystitis (AC) (n = 60), subgroup analyses were performed.ResultsBile leak developed in 11 patients with AC (18.3%), while no patients with chronic cholecystitis developed bile leak (p = 0.064). Patients with AC who underwent surgery 10 days or later from onset developed postoperative bile leak significantly more frequently than those who underwent surgery within 10 days (38.0 vs 7.6%, p = 0.003). Patients with AC who underwent gallbladder stump closure with suturing developed postoperative bile leak significantly more frequently than those who underwent ligation (37.5 vs 11.3%, p = 0.020). In the patients with AC, surgery after 10 days from onset (p = 0.022, odds ratio = 5.85) was found by logistic regression analysis to be an independent risk factor for developing postoperative bile leak.ConclusionEarly surgery yielded a lower incidence of postoperative bile leak in patients who underwent SC. Surgery during the subacute phase was considered to imply a higher risk for developing bile leak than surgery during the acute and chronic phases. More... »

PAGES

5092-5097

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00464-019-07309-5

DOI

http://dx.doi.org/10.1007/s00464-019-07309-5

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1123238816

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/31820162


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