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Article: Bile leakage after hepatobiliary and pancreatic surgery: A definition and grading of severity by the International Study Group of Liver Surgery

TitleBile leakage after hepatobiliary and pancreatic surgery: A definition and grading of severity by the International Study Group of Liver Surgery
Authors
Issue Date2011
PublisherMosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/surg
Citation
Surgery, 2011, v. 149 n. 5, p. 680-688 How to Cite?
AbstractBackground: Despite the potentially severe impact of bile leakage on patients' perioperative and long-term outcome, a commonly used definition of this complication after hepatobiliary and pancreatic operations has not yet been established. The aim of the present article is to propose a uniform definition and severity grading of bile leakage after hepatobiliary and pancreatic operative therapy. Methods: An international study group of hepatobiliary and pancreatic surgeons was convened. A consensus definition of bile leakage after hepatobiliary and pancreatic operative therapy was developed based on the postoperative course of bilirubin concentrations in patients' serum and drain fluid. Results: After evaluation of the postoperative course of bilirubin levels in the drain fluid of patients who underwent hepatobiliary and pancreatic operations, bile leakage was defined as bilirubin concentration in the drain fluid at least 3 times the serum bilirubin concentration on or after postoperative day 3 or as the need for radiologic or operative intervention resulting from biliary collections or bile peritonitis. Using this criterion severity of bile leakage was classified according to its impact on patients' clinical management. Grade A bile leakage causes no change in patients' clinical management. A Grade B bile leakage requires active therapeutic intervention but is manageable without relaparotomy, whereas in Grade C, bile leakage relaparotomy is required. Conclusion: We propose a simple definition and severity grading of bile leakage after hepatobiliary and pancreatic operative therapy. The application of the present proposal will enable a standardized comparison of the results of different clinical trials and may facilitate an objective evaluation of diagnostic and therapeutic modalities in the field of hepatobiliary and pancreatic operative therapy. © 2011 Mosby, Inc.
Persistent Identifierhttp://hdl.handle.net/10722/135544
ISSN
2023 Impact Factor: 3.2
2023 SCImago Journal Rankings: 1.096
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorKoch, Men_HK
dc.contributor.authorGarden, OJen_HK
dc.contributor.authorPadbury, Ren_HK
dc.contributor.authorRahbari, NNen_HK
dc.contributor.authorAdam, Ren_HK
dc.contributor.authorCapussotti, Len_HK
dc.contributor.authorFan, STen_HK
dc.contributor.authorYokoyama, Yen_HK
dc.contributor.authorCrawford, Men_HK
dc.contributor.authorMakuuchi, Men_HK
dc.contributor.authorChristophi, Cen_HK
dc.contributor.authorBanting, Sen_HK
dc.contributor.authorBrookeSmith, Men_HK
dc.contributor.authorUsatoff, Ven_HK
dc.contributor.authorNagino, Men_HK
dc.contributor.authorMaddern, Gen_HK
dc.contributor.authorHugh, TJen_HK
dc.contributor.authorVauthey, JNen_HK
dc.contributor.authorGreig, Pen_HK
dc.contributor.authorRees, Men_HK
dc.contributor.authorNimura, Yen_HK
dc.contributor.authorFigueras, Jen_HK
dc.contributor.authorDematteo, RPen_HK
dc.contributor.authorBüchler, MWen_HK
dc.contributor.authorWeitz, Jen_HK
dc.date.accessioned2011-07-27T01:36:50Z-
dc.date.available2011-07-27T01:36:50Z-
dc.date.issued2011en_HK
dc.identifier.citationSurgery, 2011, v. 149 n. 5, p. 680-688en_HK
dc.identifier.issn0039-6060en_HK
dc.identifier.urihttp://hdl.handle.net/10722/135544-
dc.description.abstractBackground: Despite the potentially severe impact of bile leakage on patients' perioperative and long-term outcome, a commonly used definition of this complication after hepatobiliary and pancreatic operations has not yet been established. The aim of the present article is to propose a uniform definition and severity grading of bile leakage after hepatobiliary and pancreatic operative therapy. Methods: An international study group of hepatobiliary and pancreatic surgeons was convened. A consensus definition of bile leakage after hepatobiliary and pancreatic operative therapy was developed based on the postoperative course of bilirubin concentrations in patients' serum and drain fluid. Results: After evaluation of the postoperative course of bilirubin levels in the drain fluid of patients who underwent hepatobiliary and pancreatic operations, bile leakage was defined as bilirubin concentration in the drain fluid at least 3 times the serum bilirubin concentration on or after postoperative day 3 or as the need for radiologic or operative intervention resulting from biliary collections or bile peritonitis. Using this criterion severity of bile leakage was classified according to its impact on patients' clinical management. Grade A bile leakage causes no change in patients' clinical management. A Grade B bile leakage requires active therapeutic intervention but is manageable without relaparotomy, whereas in Grade C, bile leakage relaparotomy is required. Conclusion: We propose a simple definition and severity grading of bile leakage after hepatobiliary and pancreatic operative therapy. The application of the present proposal will enable a standardized comparison of the results of different clinical trials and may facilitate an objective evaluation of diagnostic and therapeutic modalities in the field of hepatobiliary and pancreatic operative therapy. © 2011 Mosby, Inc.en_HK
dc.languageengen_US
dc.publisherMosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/surgen_HK
dc.relation.ispartofSurgeryen_HK
dc.subject.meshBile Ducts - metabolism - physiopathology-
dc.subject.meshBiliary Tract Diseases - surgery-
dc.subject.meshLiver - surgery-
dc.subject.meshPancreatic Diseases - surgery-
dc.subject.meshSeverity of Illness Index-
dc.titleBile leakage after hepatobiliary and pancreatic surgery: A definition and grading of severity by the International Study Group of Liver Surgeryen_HK
dc.typeArticleen_HK
dc.identifier.emailFan, ST: stfan@hku.hken_HK
dc.identifier.authorityFan, ST=rp00355en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.surg.2010.12.002en_HK
dc.identifier.pmid21316725-
dc.identifier.scopuseid_2-s2.0-79954631448en_HK
dc.identifier.hkuros187671en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-79954631448&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume149en_HK
dc.identifier.issue5en_HK
dc.identifier.spage680en_HK
dc.identifier.epage688en_HK
dc.identifier.isiWOS:000289930700011-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridKoch, M=7401817256en_HK
dc.identifier.scopusauthoridGarden, OJ=7006432342en_HK
dc.identifier.scopusauthoridPadbury, R=6603924012en_HK
dc.identifier.scopusauthoridRahbari, NN=21834967000en_HK
dc.identifier.scopusauthoridAdam, R=7202478918en_HK
dc.identifier.scopusauthoridCapussotti, L=7004492027en_HK
dc.identifier.scopusauthoridFan, ST=7402678224en_HK
dc.identifier.scopusauthoridYokoyama, Y=7402993620en_HK
dc.identifier.scopusauthoridCrawford, M=7402706739en_HK
dc.identifier.scopusauthoridMakuuchi, M=36050194500en_HK
dc.identifier.scopusauthoridChristophi, C=7003908136en_HK
dc.identifier.scopusauthoridBanting, S=6602131475en_HK
dc.identifier.scopusauthoridBrookeSmith, M=6505945819en_HK
dc.identifier.scopusauthoridUsatoff, V=36731616800en_HK
dc.identifier.scopusauthoridNagino, M=7006620971en_HK
dc.identifier.scopusauthoridMaddern, G=26643080100en_HK
dc.identifier.scopusauthoridHugh, TJ=7005891942en_HK
dc.identifier.scopusauthoridVauthey, JN=35270590000en_HK
dc.identifier.scopusauthoridGreig, P=7006982425en_HK
dc.identifier.scopusauthoridRees, M=7201512301en_HK
dc.identifier.scopusauthoridNimura, Y=7201351672en_HK
dc.identifier.scopusauthoridFigueras, J=7101801203en_HK
dc.identifier.scopusauthoridDematteo, RP=7006076369en_HK
dc.identifier.scopusauthoridBüchler, MW=35277875400en_HK
dc.identifier.scopusauthoridWeitz, J=7102347790en_HK
dc.identifier.issnl0039-6060-

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