Impact of postoperative bile leakage on long‐term outcome in patients following liver resection for hepatocellular carcinoma

Yamamoto, Miyako; Kobayashi, Tsuyoshi; Kuroda, Satoshi; Hamaoka, Michinori; Honmyo, Naruhiko; Yamaguchi, Megumi; Takei, Daisuke; Ohdan, Hideki

doi:10.1002/jhbp.750

Cited by 15 publications

(16 citation statements)

References 28 publications

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“…In order to evaluate the effect of postoperative BT more equitably, analysis by prospective study is desired. Third, bile leakage has been reported to have an adverse effect on overall survival [15], however, present study showed no worse relationship between bile leakage and long-term survival. In our hospital, if the bilirubin level in drainage fluid is at least five times that of serum bilirubin, we perform a repeat laparotomy as early as possible to repair the bile leakage.…”

Section: Discussioncontrasting

confidence: 71%

“…There have been only limited studies of the association between short-term and long-term outcomes after LR [14][15][16][17][18][19][20][21], although bile leakage [15,16], red blood cell transfusion (BT) [17][18][19][20], and intraperitoneal hemorrhage [21] have been shown to be complications that adversely affect long-term survival. However, which postoperative complications are long-term prognostic factors is unclear.…”

Section: Introductionmentioning

confidence: 99%

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Impact of Postoperative Complications on Long-Term Survival of Hepatocellular Carcinoma Patients After Liver Resection

Mochizuki

Nakayama

Midorikawa

et al. 2021

International Surgery

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Objective The effect of postoperative complications including red blood transfusion (BT) on long-term survival for hepatocellular carcinoma (HCC) is unknown. The purpose of this study was to define the relationship between postoperative complications and long-term survival in patients with HCC. Methods Postoperative complications of 1251 patients who underwent curative liver resection for HCC were classified, and their recurrence-free survival (RFS) and cumulative overall survival (OS) were investigated. Results Any complications occurred in 503 patients (40%). Five-year RFS and 5-year OS in the complication group were 21% and 56%, respectively, significantly lower than the respective values of 32% ( p < 0.001) and 68% ( p < 0.001) in the no-complication group (n=748). Complications related to RFS were postoperative BT [Hazard ratio (HR): 1.726, 95% confidence interval (CI): 1.338–2.228, p < 0.001], pleural effusion [HR: 1.434, 95% CI: 1.200–1.713, p < 0.001] using Cox-proportional hazard model. Complications related to OS were postoperative BT [HR: 1.843, 95%CI: 1.380-2.462, p < 0.001], ascites [HR: 1.562, 95% CI: 1.066–2.290 p = 0.022], and pleural effusion [HR: 1.421, 95% CI: 1.150–1.755, p = 0.001). Conclusions Postoperative complications were factors associated with poor long-term survival. Postoperative BT and pleural effusion, were noticeable complications that were prognostic factors for both recurrence-free survival and overall survival.

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Section: Discussioncontrasting

confidence: 71%

Section: Introductionmentioning

confidence: 99%

Impact of Postoperative Complications on Long-Term Survival of Hepatocellular Carcinoma Patients After Liver Resection

Mochizuki

Nakayama

Midorikawa

et al. 2021

International Surgery

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“…24 Yamamoto et al in a study evaluating the long-term impact of BL after liver resection for HCC found that post-operative BL was strongly associated with poorer OS and DFS following liver resection and may contribute to our understanding of the requirements for preventing BL and developing strategies towards achieving improved treatment outcomes of postoperative BL. 25 The current study has several limitations including its retrospective nature; it included data from a single center, and it included limited number of patients. Also, the number of bile leakage events was relatively small.…”

Section: Discussionmentioning

confidence: 99%

Bile Leakage After Hepatic Resection for Hepatocellular Carcinoma: Does It Impact the Short- and Long-term Outcomes?

Shehta

Farouk

Said

et al. 2022

Journal of Gastrointestinal Surgery

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Background Bile leakage (BL) is one of the commonest morbidities after hepatic resection for hepatocellular carcinoma (HCC). The current study was conducted to evaluate the incidence and different predictive factors for BL after hepatic resection for HCC, and to evaluate of the impact of BL on the long-term survival outcomes. Methods We reviewed the patients’ data who underwent hepatic resection for HCC during the period between June 2010 and June 2019. Results A total of 293 patients were included in the study. BL occurred in 17 patients (5.8%). More Child–Pugh class B patients were found in BL group. There were no significant differences between the two groups except for tumor site, macroscopic portal vein invasion, extent of liver resection, Pringle maneuver use, intraoperative blood loss, and transfusions. Longer hospital stay, higher grades of post-hepatectomy liver failure, and abdominal collections were noted in BL group. After median follow-up duration of 17 months (4–110 months), there were no significant differences between BL and non-BL group regarding overall survival (log-rank, p = 0.746) and disease-free survival (log-rank, p = 0.348). In multivariate analysis, Child–Pugh class, macroscopic portal vein invasion, liver resection extent (minor/major), and Pringle’s maneuver use were the only significant predictors of BL. Conclusion BL did not significantly impair the long-term outcomes after hepatic resection for HCC. Child–Pugh class, macroscopic portal vein invasion, liver resection extent (minor/major), and Pringle’s maneuver use were the main risk factors of BL in the current study.

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“…Abdominal infection due to bile leakage after surgery occurred in 10 patients. The influence of bile leakage ranges from a ripple to a shock, which should not be neglected 26 . Careful evaluation during operation is necessary to prevent the occurrence of bile leakage 27 .…”

Section: Discussionmentioning

confidence: 99%

Three‐day postoperative antibiotics reduces post‐hepatectomy infection rate in hepatitis B virus‐related hepatocellular carcinoma

Chen

Jiang

Wang

et al. 2021

J of Gastro and Hepatol

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Background and Aim The evidences for use of postoperative antibiotics (POA) in hepatocellular carcinoma (HCC) patients who underwent hepatectomy are controversial. We aimed to explore the relationship between POA and hepatectomy‐related infection in a hepatitis B virus (HBV)‐related HCC population. Methods We retrospectively collected 934 HCC patients who underwent hepatectomy for curative intent from three tertiary hospitals in China. The incidences of postoperative infection including surgical site infection and remote site infection were recorded and calculated. Univariable and multivariable logistic regression analyses were performed to explore related factors of postoperative infection and POA. And the relationship between infection rates with different durations of POA was investigated. Results The overall infection rate was 8.2% (77/934), including 6.5% (61/934) of surgical site infection and 2.0% (19/934) of remote site infection. Multivariable analysis revealed that the administration of POA was negatively related with the incidence of postoperative infection significantly (odds ratio = 0.50, 95% confidence interval = 0.30 to 0.83; P = 0.008). Albumin‐bilirubin score, Barcelona Clinic Liver Cancer (BCLC) stage and extent of hepatectomy were independently related to the POA. And 3‐day regimen seemed to be the shortest duration of POA to gain the lowest incidence of postoperative infection. Conclusions Postoperative antibiotic is necessary for HBV‐related HCC patients to prevent postoperative infection, especially for those with higher albumin‐bilirubin score, at BCLC stage B–C, or who underwent major hepatectomy. For HBV‐related HCC patients, postoperative second‐generation cephalosporins, or ceftriaxone for 3 days after surgery might be proper.

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Impact of postoperative bile leakage on long‐term outcome in patients following liver resection for hepatocellular carcinoma

Cited by 15 publications

References 28 publications

Impact of Postoperative Complications on Long-Term Survival of Hepatocellular Carcinoma Patients After Liver Resection

Impact of Postoperative Complications on Long-Term Survival of Hepatocellular Carcinoma Patients After Liver Resection

Bile Leakage After Hepatic Resection for Hepatocellular Carcinoma: Does It Impact the Short- and Long-term Outcomes?

Three‐day postoperative antibiotics reduces post‐hepatectomy infection rate in hepatitis B virus‐related hepatocellular carcinoma

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