Endoscopic management of biliary leakage after hepatectomy and analysis of its influencing factors

作者：Zongyan Li, Weidong Pan, Guozhi Xu, Zuxiao Chen, Lei Zhang, Zheyu Zheng, Xiaoming Huang, Liangqi Cao, Dawei Zhang · 发表于：Therapeutic Advances in Gastrointestinal Endoscopy · 年份：2025 · DOI：10.1177/26317745251388159 · 被引用次数：2 · 研究领域：Gallbladder and Bile Duct Disorders、Organ Transplantation Techniques and Outcomes、Pancreatic and Hepatic Oncology Research

Background: Bile leakage following hepatectomy is a challenging issue that poses difficulties for hepatobiliary surgeons. Endoscopic treatment is the primary method for managing this complication, although its effectiveness is still uncertain. Objectives: The aim of this study was to assess the effectiveness and risk factors of endoscopic treatment for bile leakage after hepatectomy. Design: A retrospective cohort study. Methods: A retrospective study was performed on 15 patients who experienced bile leakage following hepatectomy and were successfully treated with endoscopic retrograde cholangiography (ERCP). The primary focus was to examine how factors like the site of bile leakage, the position of biliary drainage, and late-set leakage impact early clinical success (ECS). Results: Out of the 15 cases, 10 successfully achieved ECS through endoscopic treatment. The highest success rate (80.0%, 4 out of 5) was seen when biliary drainage was performed by bridging, while drainage placed near the leakage site had a success rate of 75.0% (6 out of 8). The best outcomes occurred when bile leakage was located in the tertiary or higher branch bile ducts, with an 83.3% success rate (5 out of 6). Additionally, early-onset leakage had a higher ECS success rate compared to late-onset bile leakage (75.0% (6/8) vs 57.1% (4/7)). Among the 15 cases, 12 involved extensive liver resections of more than two segments, 14 included segments 7 or 8, 11 had received preoperative adjuvant therapy, an...