Tan Ling, Liu Fei, Liu Zi-Lin, Xiao Jiang-Wei
Department of Gastrointestinal Surgery, Clinical Medical College and the First Affiliated Hospital of Chengdu Medical College, Chengdu, China.
Front Surg. 2021 Nov 1;8:764211. doi: 10.3389/fsurg.2021.764211. eCollection 2021.
The risk factors for bile leakage after hepatectomy without biliary reconstruction are controversial. This study investigated the risk factors for bile leakage after hepatectomy without biliary reconstruction. We searched databases (Embase (Ovid), Medline (Ovid), PubMed, Cochrane Library, and Web of Science) for articles published between January 1, 2000, and May 1, 2021, to evaluate the risk factors for bile leakage after hepatectomy without biliary reconstruction. A total of 16 articles were included in this study, and the overall results showed that sex (OR: 1.21, 95% CI: 1.04-1.42), diabetes (OR: 1.21, 95% CI: 1.05-1.38), left trisectionectomy (OR: 3.53, 95% CI: 2.32-5.36), central hepatectomy (OR: 3.28, 95% CI: 2.63-4.08), extended hemihepatectomy (OR: 2.56, 95% CI: 1.55-4.22), segment I hepatectomy (OR: 2.56, 95% CI: 1.50-4.40), intraoperative blood transfusion (OR:2.40 95%CI:1.79-3.22), anatomical hepatectomy (OR: 1.70, 95% CI: 1.19-2.44) and intraoperative bleeding ≥1,000 ml (OR: 2.46, 95% CI: 2.12-2.85) were risk factors for biliary leakage. Age >75 years, cirrhosis, underlying liver disease, left hepatectomy, right hepatectomy, benign disease, Child-Pugh class A/B, and pre-operative albumin <3.5 g/dL were not risk factors for bile leakage after hepatectomy without biliary reconstruction. Comprehensive research in the literature revealed that sex, diabetes, left trisectionectomy, central hepatectomy, extended hemihepatectomy, segment I hepatectomy, intraoperative blood transfusion, anatomical hepatectomy and intraoperative bleeding ≥1,000 ml were risk factors for biliary leakage.
肝切除术后未进行胆道重建时胆漏的危险因素存在争议。本研究调查了肝切除术后未进行胆道重建时胆漏的危险因素。我们检索了数据库（Embase（Ovid）、Medline（Ovid）、PubMed、Cochrane图书馆和Web of Science），以获取2000年1月1日至2021年5月1日期间发表的文章，以评估肝切除术后未进行胆道重建时胆漏的危险因素。本研究共纳入16篇文章，总体结果显示，性别（OR：1.21，95%CI：1.04-1.42）、糖尿病（OR：1.21，95%CI：1.05-1.38）、左三叶切除术（OR：3.53，95%CI：2.32-5.36）、中央肝切除术（OR：3.28，95%CI：2.63-4.08）、扩大半肝切除术（OR：2.56，95%CI：1.55-4.22）、Ⅰ段肝切除术（OR：2.56，95%CI：1.50-4.40）、术中输血（OR：2.40，95%CI：1.79-3.22）、解剖性肝切除术（OR：1.70，95%CI：1.19-2.44）和术中出血≥1000ml（OR：2.46，95%CI：2.12-2.85）是胆漏的危险因素。年龄>75岁、肝硬化、潜在肝脏疾病、左肝切除术、右肝切除术、良性疾病、Child-Pugh A/B级以及术前白蛋白<3.5g/dL不是肝切除术后未进行胆道重建时胆漏的危险因素。文献中的综合研究表明，性别、糖尿病、左三叶切除术、中央肝切除术、扩大半肝切除术、Ⅰ段肝切除术、术中输血、解剖性肝切除术和术中出血≥1000ml是胆漏的危险因素。
