Risk factors determining bile leakage after multiple liver hydatid cyst surgery

Yılmaz Özdemir; İlter Ozer; Ali Sürmelioğlu; Tahsin Dalgıç; Erol Aksoy; Mehmet Ali Çaparlar; Murat Ulaş; Yusuf Bayram Özoğul; Erdal Birol Bostancı; Musa Akoğlu

doi:10.28982/josam.1072054

Authors

Yılmaz Özdemir https://orcid.org/0000-0002-5480-1140
İlter Ozer https://orcid.org/0000-0001-6902-0913
Ali Sürmelioğlu 3Department of Gastrointestinal Surgery, Haydarpaşa Numune Training and Research Hospital,İstanbul, Turkey https://orcid.org/0000-0002-7697-0930
Tahsin Dalgıç Department of Gastrointestinal Surgery, Ankara City Hospital, Ankara, Turkey https://orcid.org/0000-0003-0677-2944
Erol Aksoy Department of Gastrointestinal Surgery, Ankara City Hospital, Ankara, Turkey https://orcid.org/0000-0003-2553-4052
Mehmet Ali Çaparlar Department of Surgical Oncology, Ankara University Faculty of Medicine, Ankara, Turkey https://orcid.org/0000-0001-7854-3265
Murat Ulaş 2Department of Gastrointestinal Surgery, Osmangazi University Faculty of Medicine, Eskişehir, Turkey https://orcid.org/0000-0002-3507-8647
Yusuf Bayram Özoğul Department of Gastrointestinal Surgery, Ankara City Hospital, Ankara, Turkey https://orcid.org/0000-0002-9953-2343
Erdal Birol Bostancı Department of Gastrointestinal Surgery, Ankara City Hospital, Ankara, Turkey https://orcid.org/0000-0002-0663-0156
Musa Akoğlu Department of Gastrointestinal Surgery, Ankara City Hospital, Ankara, Turkey https://orcid.org/0000-0001-9429-2689

DOI:

https://doi.org/10.28982/josam.1072054

Keywords:

Liver, Hydatid cyst, Bile leak

Abstract

Background/Aim: Biliary leaks are the main source of morbidity after liver hydatid cyst surgery. Many identified factors have been examined in predicting biliary leaks. The aim of this study was to determine the postoperative bile leakage rate and predictive factors affecting bile leakage in multiple liver hydatid cysts. Method: In our retrospective cohort study, the data of 130 patients who underwent multiple liver hydatid surgery in our clinic between January 2007 and November 2013 were analyzed. Results: In the 130 patients with multiple cysts, 323 hydatid cysts were detected. The number of cysts was 2 in 65.4% of the patients, and 3 or more in 34.6% of the patients. The postoperative bile leakage rate was 19.2%. According to the univariate analyses, during the preoperative period, the presence of jaundice, fever, leukocytosis, eosinophilia, aspartate aminotransferase, alanine aminotransferase, gamma glutamyl transferase, alkaline phosphatase, and direct bilirubin increase, the largest cyst being located in the perihilar region, the mean diameter of the cyst, the diameter of the largest cyst, biliary tract dilatation on the preoperative images, and infection were associated with increased postoperative bile leakage. In the multivariate analyses, eosinophilia and biliary tract dilatation on the preoperative images were found to be independent risk factors for postoperative bile leakage. Conclusion: In this study, the most determining factors for bile leakage after multiple liver hydatid cyst surgery were a high eosinophil rate and the presence of dilatation in the biliary tract on the preoperative radiological images.

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