Risk factors and outcomes of bile leak after laparoscopic surgery for congenital biliary dilatation
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In brief
In brief
This retrospective study of 78 laparoscopic congenital biliary dilatation cases identifies hepatic duct diameter ≤10mm as the primary bile leak risk factor, with higher rates among non-qualified surgeons. Despite 18% bile leak incidence in narrow-duct cases, no patients developed anastomotic stricture, suggesting minor leaks may not compromise long-term outcomes.
Written by the GCMD Library team from the article.
Abstract
Purpose
One of the main causes of stricture at hepaticojejunostomy site after surgery for congenital biliary dilatation is inflammation or infection associated with bile leak. The aim of this study was to determine the risk factors and outcomes of bile leak after laparoscopic surgery.
Methods
We retrospectively reviewed the demographics and outcomes of patients who underwent laparoscopic surgery for congenital biliary dilatation between September 2013 and December 2019. Data from patients with bile leak were compared to data from patients without bile leak.
Results
Fourteen of 78 patients had bile leak. Hepatic duct diameter at anastomosis was the only risk factor of bile leak. Patients with the diameter ≤ 10 mm had higher incidence of bile leak than in patients with the diameter > 10 mm (P = 0.0023). Among them, bile leak occurred more frequently in patients operated on by non-qualified surgeons based on the Japan Society for Endoscopic Surgery endoscopic surgical skill qualification system than by qualified surgeons (P = 0.027). However, none of the patients with bile leak developed anastomotic stricture afterwards.
Conclusion
Although good technical skill is necessary to avoid bile leak in narrow hepatic duct cases (≤ 10 mm), slight bile leak may not result in anastomotic stricture.