Bile Leakage Test in Hepatectomy - Is Better When It Bubbles?

D'Oliveira, Marcelo Silveira; Vasconcelos, Hanna; Steinbrück, Klaus; Rodrigues, Luiza; Fernandes, Reinaldo; Capelli, Rafaela; Cano, Renato; Enne, Marcelo

doi:10.5455/ijmrcr.bile-leakage-test-in-hepatectomy

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“… 4 , 27 Even though there was no statistical difference between both groups (p=0.506), the re-hepatectomy group had a greater tendency to develop biliary leak complications. This could be explained by the difficulties to identify the cystic duct and perform the bile leak test 11 in patients formerly submitted to cholecystectomy - commonly executed during first hepatectomy. Most of the observed biliary complications could be considered benign and were treated conservatively.…”

Section: Discussionmentioning

confidence: 99%

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Re-Hepatectomy Means More Morbidity? A Multicentric Analysis

Basilio¹,

Steinbrück

Fernandes

et al. 2022

ABCD, arq. bras. cir. dig.

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- BACKGROUND: Colorectal cancer generally metastasizes to the liver. Surgical resection of liver metastasis, which is associated with systemic chemotherapy, is potentially curative, but many patients will present recurrence. In selected patients, repeated hepatectomy is feasible and improves overall survival. AIM: This study aimed to analyze patients with colorectal liver metastasis (CRLM) submitted to hepatectomy in three centers from Rio de Janeiro, over the past 10 years, by comparing the morbidity of first hepatectomy and re-hepatectomy. METHODS: From June 2009 to July 2020, 192 patients with CRLM underwent liver resection with curative intent in three hospitals from Rio de Janeiro Federal Health System. The data from patients, surgeries, and outcomes were collected from a prospectively maintained database. Patients submitted to first and re-hepatectomies were classified as Group 1 and Group 2, respectively. Data from groups were compared and value of p<0.05 was considered significant. RESULTS: Among 192 patients, 16 were excluded. Of the remaining 176 patients, 148 were included in Group 1 and 28 were included in Group 2. Fifty-five (37.2%) patients in Group 1 and 13 (46.5%) in Group 2 presented postoperative complications. Comparing Groups 1 and 2, we found no statistical difference between the cases of postoperative complications (p=0.834), number of minor (p=0.266) or major (p=0.695) complications, and deaths (p=0.407). CONCLUSIONS: No differences were recorded in morbidity or mortality between patients submitted to first and re-hepatectomies for CRLM, which reinforces that re-hepatectomy can be performed with outcomes comparable to first hepatectomy.

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Section: Discussionmentioning

confidence: 99%

“…The Pringle maneuver and the energy devices (monopolar and bipolar cauterizers, vessel sealing device) were used to diminish blood loss. To avoid biliary complications, biliary leakage test 11 was performed, whenever possible.…”

Section: Methodsmentioning

confidence: 99%