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Title: The role of bile leak testing in liver resection: a systematic review and meta-analysis.
Epworth Authors: Vaska, Aarathi
Abbas, Sahel
Keywords: Bile Leak
Liver Resection
Systematic Review
Intraoperative Bile Leak Testing
Postoperative Bile Leak Rate
Biliary Reconstruction
Reintervention Rate
Duration of Hospital Stay
General Surgery and Gastroenterology Clinical Institute, Epworth HealthCare, Victoria, Australia
Issue Date: Sep-2018
Publisher: Elsevier
Citation: HPB (Oxford). 2018 Sep 20. pii: S1365-182X(18)32693-5.
Abstract: BACKGROUND: Bile leak following liver resection can be associated with significant morbidity. This systematic review and meta-analysis aims to evaluate the effect of intraoperative bile leak testing on postoperative bile leak rate and other complications after liver resection without biliary reconstruction for any cause. METHODS: PubMed, MEDLINE, Embase, Cochrane Library and grey literature databases were searched for articles between 1960 and 2017 comparing bile leak rates with or without bile leak testing. Standard meta-analysis methods were used. The primary outcome was bile leak rate, and secondary outcomes were overall morbidity, reintervention rate and length of stay. RESULTS: 8 articles met inclusion criteria. Intraoperative bile leak testing after resection was associated with lower postoperative bile leak rate (4.1% vs 12.3%, OR 0.36, 95% CI 0.23-0.55, p < 0.001), overall morbidity (OR 0.67, 95% CI 0.47-0.96, p = 0.030), need for reintervention (OR 0.11, 95% CI 0.03-0.36, p < 0.001) and a shorter duration of hospital stay (2.21 days, 95% CI 0.69-3.73, p = 0.004). CONCLUSION: The routine use of intraoperative bile leak testing during liver resection results in a significant reduction in postoperative bile leak rate, overall morbidity, length of hospital stay and need for re-intervention. Bile leak testing should be performed after liver resection without biliary reconstruction.
DOI: 10.1016/j.hpb.2018.07.008
PubMed URL:
ISSN: 1365-182X
Journal Title: HPB : the official journal of the International Hepato Pancreato Biliary Association
Type: Journal Article
Affiliated Organisations: Department of Surgery, University Hospital Geelong, Victoria, Australia
School of Medicine, Deakin University Geelong, Victoria, Australia
Type of Clinical Study or Trial: Meta-Analysis
Appears in Collections:General Surgery and Gastroenterology

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