Prospective evaluation of the International Study Group for Liver Surgery definition of bile leak after a liver resection and the role of routine operative drainage: An international multicentre study

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Mark Brooke-Smith - , Flinders University (Author)
  • Joan Figueras - , Josep Trueta University Hospital (Author)
  • Shahid Ullah - , Flinders University (Author)
  • Myrddin Rees - , Hampshire Hospitals NHS Foundation Trust (Author)
  • Jean Nicolas Vauthey - , University of Texas at Austin (Author)
  • Thomas J. Hugh - , Royal North Shore Hospital (Author)
  • O. James Garden - , University of Edinburgh (Author)
  • Sheung Tat Fan - , The University of Hong Kong (Author)
  • Michael Crawford - , Royal Prince Alfred Hospital (Author)
  • Masatoshi Makuuchi - , Japanese Red Cross Medical Center (Author)
  • Yukihiro Yokoyama - , Nagoya University (Author)
  • Marcus Büchler - , TUD Dresden University of Technology (Author)
  • Juergen Weitz - , Department of Visceral, Thoracic and Vascular Surgery, TUD Dresden University of Technology (Author)
  • Robert Padbury - , Flinders University (Author)

Abstract

Background The International Study Group for Liver Surgery (ISGLS) proposed a definition for bile leak after liver surgery. A multicentre international prospective study was designed to evaluate this definition. Methods Data collected prospectively from 949 consecutive patients on specific datasheets from 11 international centres were collated centrally. Results Bile leak occurred in 69 (7.3%) of patients, with 31 (3.3%), 32 (3.4%) and 6 (0.6%) classified as grade A, B and C, respectively. The grading system of severity correlated with the Dindo complication classification system (P < 0.001). Hospital length of stay was increased when bile leak occurred, from a median of 7 to 15 days (P < 0.001), as was intensive care stay (P < 0.001), and both correlated with increased severity grading of bile leak (P < 0.001). 96% of bile leaks occurred in patients with intra-operative drains. Drain placement did not prevent subsequent intervention in the bile leak group with a 5-15 times greater risk of intervention required in this group (P < 0.001). Conclusion The ISGLS definition of bile leak after liver surgery appears robust and intra-operative drain usage did not prevent the need for subsequent drain placement.

Details

Original languageEnglish
Pages (from-to)46-51
Number of pages6
JournalHPB
Volume17
Issue number1
Publication statusPublished - 1 Jan 2015
Peer-reviewedYes

External IDs

PubMed 25059275

Keywords

ASJC Scopus subject areas