• Kenji Okumura, Keishi Sugimachi, Nao Kinjo, Fumihiro Shoji, Masahiko Ikebe, Ichiro Makino, and Hidefumi Higashi.
• Hepato Gastroenterol. 2013 Oct 1;60(127):1717-9.

Background/AimsTo identify the risk factors for postoperative biliary complications after hepatic resection for hepatocellular carcinoma.MethodologyThe subjects were 123 patients who underwent hepatic resection for hepatocellular carcinoma between January 2006 and December 2010. Perioperative factors related to postoperative bile leakage were studied.ResultsPostoperative bile leakage occurred in eight (6.5%) of the patients. Univariate analysis showed that liver fibrosis or cirrhosis (p=0.007), long operation time (>5 hours) (p=0.002), major hepatic resection (p=0.024) and hepatectomy including Couinaud's segment 4 (p=0.0078) or segment 5 (p=0.023) were associated with an incidence of bile leakage. From multivariate analysis, operation time (relative risk=6.10, p=0.026) or resection of segment 4 (relative risk=6.86, p=0.017) were found to be independent risk factors for bile leakage.ConclusionsProlonged operation time and hepatectomy including segment 4 led to a high risk for postoperative bile leakage in this series of patients.

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