It was reported via journal article "title: bile leakage and liver resection; where is the risk?" authors: lorenzo capussotti, md; alessandro ferrero, md; luca viganò, md; enrico sgotto, md; andrea muratore, md; roberto polastri, md citation: arch surg.2006; 141: 690-694.The aim of this study was to investigate the perioperative risk factors related to postoperative bile leakage, placing particular focus on anatomical and technical variables.Prospectively collected clinical data on 610 consecutive patients (369 male and 241 female patients; age range: 2 to 86 years old) who underwent liver resection in our department from january 1, 1989, through january 31, 2003, were reviewed retrospectively.During the surgical procedure, the parenchymal transection was always performed by using a crushing clamp technique and absolok extra absorbable clips (ethicon) for any vessel or bile duct.When necessary, biliostasis was attained by suturing the identified bile leakage site with pds ii 5-0 or 6-0 absorbable monofilament (ethicon).Reported complications included post-operative bile leakage (n-22) in which bile leakage spontaneously healed in 15 patients, endoscopic sphincterotomy in 7, percutaneous drainage in 3, and re-operation in 2 patients, one patient with bile leakage died due to onset of sepsis, and among patients with bile leakage, 4 patients had additional complications.It was concluded that hepatectomies including segment 4, especially if performed for peripheral cholangiocarcinoma, place the patient at higher risk for postoperative bile leakage.Careful surgical technique is mandatory to avoid bile leakage.Treatment of the cut surface with fibrin glue reduces the risk of postoperative bile leakage.Use of these techniques is warranted to reduce bile leakage in hepatic resection.
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