Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
Department of Surgery, Hyogo Cancer Center, 13-70 Kitaoji-cho, Akashi, 673-8558, Japan.
Langenbecks Arch Surg. 2024 Jul 30;409(1):233. doi: 10.1007/s00423-024-03430-9.
The impact of postoperative bile leak on the prognosis of patients with hepatocellular carcinoma who underwent liver resection is controversial. This study aimed to investigate the prognostic impact of bile leak for patients with hepatocellular carcinoma who underwent liver resection.
Patients with hepatocellular carcinoma who underwent liver resection between 2009 and 2019 at Kobe University Hospital and Hyogo Cancer Center were included. After propensity score matching between the bile leak and no bile leak groups, differences in 5-year recurrence-free and overall survival rates were evaluated using the Kaplan-Meier method.
A total of 781 patients, including 43 with postoperative bile leak, were analyzed. In the matched cohort, 40 patients were included in each group. The 5-year recurrence-free survival rates after liver resection were 35% and 32% for the bile leak and no bile leak groups, respectively (P = 0.857). The 5-year overall survival rates were 44% and 54% for the bile leak and no bile leak groups, respectively (P = 0.216).
Overall, bile leak may not have a profound negative impact on the prognosis of patients with hepatocellular carcinoma who have undergone liver resection.
术后胆漏对接受肝切除术的肝细胞癌患者预后的影响存在争议。本研究旨在探讨肝切除术后胆漏对肝细胞癌患者预后的影响。
纳入 2009 年至 2019 年在神户大学医院和兵库癌症中心接受肝切除术的肝细胞癌患者。在胆漏组和无胆漏组之间进行倾向评分匹配后，采用 Kaplan-Meier 法评估两组患者 5 年无复发生存率和总生存率的差异。
共分析了 781 例患者，其中 43 例术后发生胆漏。在匹配队列中，每组各有 40 例患者。肝切除术后 5 年无复发生存率分别为胆漏组 35%和无胆漏组 32%（P=0.857）。5 年总生存率分别为胆漏组 44%和无胆漏组 54%（P=0.216）。
总体而言，胆漏可能不会对接受肝切除术的肝细胞癌患者的预后产生深远的负面影响。
