Factors Affecting Clinical Course of Postoperative Bile Leakage and Efficacy of Endoscopic Biliary Drainage: A Multi‐Center Retrospective Cohort Study
Year: 2025
Type: article
Study design: Observational Study
Abstract: Introduction Bile leakage is one of the complications after hepatobiliary surgery, causing intra‐abdominal infections, and is sometimes difficult to treat. The purpose of our study was to investigate the factors related to severity and to evaluate the efficacy of endoscopic treatment. Methods This was a retrospective multicenter cohort study conducted at three tertiary care medical centers. The severity of bile leakage was classified per the International Study Group of Liver Surgery, and Grades B and C (requiring some intervention or reoperation) were considered as severe. Results The subjects were 59 patients. The surgical procedures were 31 cholecystectomies, 23 hepatectomies, and five pancreaticoduodenectomies. The severity was Grade A/B/C: 17/40/2. Multivariate logistic regression analysis found that age (unit odds ratio [UOR], 1.09; 95% confidence interval [CI], 1.0–1.19; p = 0.049) and days from surgery to bile leak (UOR, 1.18; 95% CI, 1.04–1.35; p = 0.012) were independent predictors of bile leak severity. Of 40 Grade B biliary leakage patients, 37 patients underwent endoscopic drainage, of which 11 also received intra‐abdominal abscess drainage. Eventually, bile leakage was successfully treated in all patients after several endoscopic drainage sessions, and the median drainage period was 18 days (inter‐quartile range: 13–35). Conclusion In the management of bile leakage after hepatobiliary surgery, elderly patients or patients with late onset of bile leak may be at high risk of severity. Endoscopic biliary drainage is considered a safe and effective treatment for severe patients.
Source: DEN Open
DOI: 10.1002/deo2.70161
Authors: Kota Shimojo, Takuji Iwashita, Keisuke Iwata, Yuki Utakata, Kaori Koide, Takuya Koizumi, Yuki Ito, Yosuke Ohashi, Shota Iwata, Akihiko Senju, Ryuichi Tezuka, Hironao Ichikawa, Yuhei Iwasa, Naoki Mita, Mitsuru Okuno, Kensaku Yoshida, Akinori Maruta, Shinya Uemura, Masahiko Kawai, Yoshiyuki Sasaki, Katsutoshi Murase, Nobuhisa Matsuhashi, Masahito Shimizu
Language: English
Subfield: Gastroenterology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,500
OpenAlex ID: W4411223627