The impact of bile leakage on long-term prognosis in primary liver cancers after hepatectomy: A propensity-score-matched study

Wang, Jian; Zhao, Jianping; Wang, Jingjing; Chai, Songshan; Zhang, Yuxin; Zhang, Zhanguo; Xiang, Shuai; Chen, Xiaoping; Zhang, Wanguang

doi:10.1016/j.asjsur.2019.08.009

Cited by 8 publications

(10 citation statements)

References 52 publications

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“…The 195 papers were included for the title and abstract screening, and 42 studies with full‐text available were eventually selected for meta‐analysis. Among the included studies, 39 were used to analyze the risk factors for POBL, 4,5,9,11–15,20–52 while the other 5 were used to estimate the prognostic values of POBL on liver resection 11,53,54,55,56 …”

Section: Resultsmentioning

confidence: 99%

“…Among the included studies, 39 were used to analyze the risk factors for POBL, 4,5,9,[11][12][13][14][15] while the other 5 were used to estimate the prognostic values of POBL on liver resection. 11,53,54,55,56 A total of 39 studies with 43,824 patients were included, with 33 (84.62%) retrospective studies and 6 (15.38%) prospective studies (Table 1). All the studies were measured with a "High" NOS quality score, indicating the comprehensive information provided (Table S2).…”

Section: Evidence Synthesis and Characteristics Of The Eligible Studiesmentioning

confidence: 99%

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Risk factors of postoperative bile leakage after liver resection: A systematic review and meta‐analysis

et al. 2023

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ObjectivePostoperative bile leakage (POBL) is one of the most common complications after liver resection. However, current studies on the risk factors for POBL and their impacts on surgical outcomes need to be more consistent. This study aims to conduct a meta‐analysis to analyze the risk factors for POBL after hepatectomy.MethodsWe incorporated all eligible studies from Embase, PubMed, and the Web of Science database (until July 2022) into this study. RevMan and STATA software were used to analyze the extracted data.ResultsA total of 39 studies, including 43,824 patients, were included in this meta‐analysis. We found that gender, partial hepatectomy, repeat of hepatectomy, extended hepatectomy, abdominal drain, diabetes, Child≥B, solitary tumor, and chemotherapy are the factors of grade B and C POBL. Some recognized risk factors were considered potential risk factors for grade B and C bile leakage because no subgroup analysis was performed, like HCC, cholangiocarcinoma, major resection, posterior sectionectomy, bi‐segmentectomy, S4 involved, S8 involved, central hepatectomy, and bile duct resection/reconstruction. Meanwhile, cirrhosis, benign diseases, left hepatectomy, and Segment 1 resection were not significant for grade B and C bile leakage. The influence of lateral sectionectomy, anterior sectionectomy, S1 involved, S3 involved, high‐risk procedure, laparoscope, and blood loss>1000 mL on POBL of ISGLS needs further research. Meanwhile, POBL significantly influenced overall survival (OS) after liver resection.ConclusionsWe identified several risk factors for POBL after hepatectomy, which could prompt the clinician to decrease POBL rates and make more beneficial decisions for patients who underwent the hepatectomy.

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Section: Resultsmentioning

confidence: 99%

Section: Evidence Synthesis and Characteristics Of The Eligible Studiesmentioning

confidence: 99%

Risk factors of postoperative bile leakage after liver resection: A systematic review and meta‐analysis

et al. 2023

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“…There are also several reports on the relationship between intraoperative bleeding and PHBL. Wang et al [22] reported that tumor size, type of tumor, surgical duration time, blood loss, and blood transfusion were the independent risk factors for PHBL.…”

Section: (Which Was Not Certified By Peer Review)mentioning

confidence: 99%

Impact of sarcopenic obesity on post-hepatectomy bile leakage for hepatocellular carcinoma

Hayashi

Shimizu

Koyama

et al. 2023

Preprint

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Background: Post-hepatectomy bile leakage (PHBL) is a potentially fatal complication that can arise after hepatectomy. Previous studies have identified obesity as a risk factor for PHBL. Therefore, we investigated the impact of sarcopenic obesity on PHBL in hepatocellular carcinoma (HCC) patients. Methods: In total, we enrolled 409 patients who underwent hepatectomy without bilioenteric anastomosis for HCC between January 2010 and August 2021. Patients were grouped according to the presence or absence of PHBL. Patient characteristics including body mass index and sarcopenic obesity were then analyzed for predictive factors for PHBL. Results: Among the 409 HCC patients included in this study, 39 developed PHBL. Male gender, hypertension and cardiac disease, white blood cell counts, the psoas muscle area and visceral fat area, and intraoperative blood loss were significantly increased in the PHBL (+) group compared with the PHBL (−) group. Multivariate analysis showed that independent risk factors for the occurrence of PHBL were intraoperative blood loss ≥370 mL and sarcopenic obesity. Conclusion: Our results show that it is important to understand whether a patient is at high risk for PHBL prior to surgery and especially to reduce intraoperative blood loss during surgery for patients with risk factors for PHBL.

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“…The type of hepatectomy was decided based on the tumor and liver condition for each patient, as described previously. 17 The reverse Trendelenburg position was routinely applied, but the lateral position was used for right hepatectomy. Pneumoperitoneum pressure was maintained at 10-12 mmHg, and the Pringle maneuver was performed during surgery if necessary.…”

Section: Surgery Techniquesmentioning

confidence: 99%

Construction and Validation of a Nomogram for Predicting the Risk of Deep Vein Thrombosis in Hepatocellular Carcinoma Patients After Laparoscopic Hepatectomy: A Retrospective Study

Yao

Zhao

Zhang

et al. 2021

JHC

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Background:The incidence of deep vein thrombosis (DVT) in hepatocellular carcinoma (HCC) patients after laparoscopic hepatectomy (LH) is unclear, and there is no effective method for DVT risk assessment in these patients. Methods: The data from the total of 355 consecutive HCC patients who underwent LH were included. A DVT risk algorithm was developed using a training set (TS) of 243 patients, and its predictive performance was evaluated in both the TS and a validation set (VS) of 112 patients. The model was then used to develop a DVT risk nomogram (TRN). Results: The incidence of DVT in the present study was 18.6%. Age, sex, body mass index (BMI), comorbidities and operative position were independent risk factors for DVT in the TS. The model based on these factors had a good predictive ability. In the TS, it had an area under the receiver operating characteristic (AUC) curve of 0.861, Hosmer-Lemeshow (H-L) goodness of fit p value of 0.626, sensitivity of 44.4%, specificity of 96.5%, positive predictive value (PPV) of 74.1%, negative predictive value (NPV) of 88.4%, and accuracy of 86.8%. In the VS, it had an AUC of 0.818, H-L p value of 0.259, sensitivity of 38.1%, specificity of 98.9%, PPV of 88.9%, NPV of 87.4%, and accuracy of 87.5%. The TRN performed well in both the internal and the external validation, indicating a good clinical application value. The TRN had a better predictive value of DVT than the Caprini score (p < 0.001). Conclusion:The incidence of DVT after LH was high, and should not be neglected in HCC patients. The TRN provides an efficacious method for DVT risk evaluation and individualized pharmacological thromboprophylaxis.

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The impact of bile leakage on long-term prognosis in primary liver cancers after hepatectomy: A propensity-score-matched study

Cited by 8 publications

References 52 publications

Risk factors of postoperative bile leakage after liver resection: A systematic review and meta‐analysis

Risk factors of postoperative bile leakage after liver resection: A systematic review and meta‐analysis

Impact of sarcopenic obesity on post-hepatectomy bile leakage for hepatocellular carcinoma

Construction and Validation of a Nomogram for Predicting the Risk of Deep Vein Thrombosis in Hepatocellular Carcinoma Patients After Laparoscopic Hepatectomy: A Retrospective Study

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