Abstract:

Objective

To investigate the influencing factors of bile leakage in patients with liver trauma and rupture after treatment.

Methods

Clinical data of 357 patients with liver trauma and rupture admitted to the 909^th Hospital from January 2006 to December 2019 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them，227 patients were male and 130 female，aged 21-64 years，with a median age of 44 years. According to American Association for the Surgery of Trauma （AAST） grading scale，125 cases were classified as gradeⅠ，201 cases as grade Ⅱ-Ⅲ，and 31 cases as grade Ⅳ-Ⅴ. 177 cases received surgery，122 cases by interventional therapy and 58 cases by conservative treatment after liver trauma and rupture. Logistic regression model was used for multivariate analysis of bile leakage.

Results

Bile leakage occurred in 56 cases after liver trauma and rupture，and the incidence of bile leakage was 15.7% （56/357）. Among them，35 cases were classified as grade A and 21 cases as grade B based on the International Study Group of Liver Surgery （ISGLS）classification. Multivariate Logistic analysis showed that Child-Pugh B and C，non-surgical treatment，bleeding volume ≥400 ml，T-tube free drainage，and grade Ⅱ-Ⅴ liver trauma were the independent risk factors for bile leakage （OR=4.121，3.575，12.923，72.168，5.501； P＜0.05）.

Conclusions

The incidence of bile leakage is high in patients with liver trauma and rupture. Liver function classification，treatment method，blood loss，T-tube drainage and liver trauma classification are the independent influencing factors for bile leakage. Extensive attention should be paid to preventing risk factors. Effective surgical treatment strategies should be employed to reduce the incidence of bile leakage.

Key words: Liver trauma, Bile leakage, Influencing factors, Surgical procedures，operative