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Novel algorithm for the diagnosis and treatment of different types of bile leakage following liver surgery
By Abbasi Dezfouli S, Heidenreich E, Shahrbaf M and 7 others.
Abstract
Background
Posthepatectomy bile leakage (PHBL) after liver resection with bilioenteric anastomosis may originate from the anastomosis (anastomotic leak (AL)) or the transection surface (surface leak), including leakage from isolated bile ducts (IBDLs). Differentiating these sources remains challenging, and standardized management guidelines are lacking.
Methods
All patients undergoing liver resection with bilioenteric anastomosis from 2008-2023 were analysed. PHBL was classified by origin (AL, surface leak, IBDL) and timing (early versus late onset). Drain fluid bilirubin concentration, drain-to-serum bilirubin ratio, and daily bilirubin loss were evaluated by leak type. Outcomes of conservative, interventional, and surgical management were compared.