Risk factors, treatment and impact on outcomes of bile leakage after hemihepatectomy

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Hepatectomy is the current main treatment for benign and malignant liver tumours and hepatolithiasis. As technology and surgical procedures advance, complications associated with hepatectomy and subsequent mortality rates have declined. However, hemihepatectomy is still a high‐risk procedure because of the large number of liver resections and the complexity of the operation.
Bile leakage is a major complication of liver resection. Previous studies have shown that the rate of bile leakage after liver resection is 3.6–7.4%.1 However, without a uniform standard for the diagnosis of bile leakage prior to 2011, it is difficult to compare bile leakage studies. In 2011, the International Study Group of Liver Surgery (ISGLS) developed a standard for diagnosing bile leakage.7 Due to the sensitivity of the standard, bile leakage rates after hepatic resection increased considerably to 16%, 27.2% and 35.7% in the recent three articles.7
Certain types of hepatectomy can significantly influence the probability of bile leakage, such as anterior segmentectomy, central bisegmentectomy and total caudate lobectomy.3 Hemihepatectomy is a single and fixed type of hepatectomy, which could avoid the influence on researching the bile leakage risk factors, so the study on the bile leakage of hemihepatectomy may be more meaningful.
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