Risk factors of bile leakage after hepatectomy for hepatocellular carcinoma

Background/Aims: To identify the risk factors for postoperative biliary complications after hepatic resection for hepatocellular carcinoma. Methodology: The 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. Results: Postoperative 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. Conclusions: Prolonged operation time and hepatectomy including segment 4 led to a high risk for postoperative bile leakage in this series of patients.