Bilirubin level fluctuation in drain discharge after hepatectomies justifies long-term drain maintenance

Guido Torzilli, Natale Olivari, Daniele Del Fabbro, Andrea Gambetti, Piera Leoni, Adele Gendarini, Masatoshi Makuuchi

Research output: Contribution to journalArticlepeer-review

Abstract

Background/Aims: Need for abdominal drains after liver resection is debated. However, unrecognized bile leak is relatively frequent: to prevent bile collection we adopted the use of long-term drains. The aim of this study was to validate this policy checking the bilirubin concentration in the drain discharge and serum along the postoperative course. Methodology: A prospective cohort study enrolling 58 consecutive patients with liver tumors was carried out. All patients underwent liver resection and received abdominal drains which were maintained for at least 7 days postoperatively. The bilirubin concentration in serum and drain discharge was sampled on the 3rd, 5th and 7th postoperative days. Results: No postoperative mortality and major morbidity were observed. The bilirubin level in drain discharge was higher on the 5th postoperative day than on the 3rd and 7th postoperative days: difference between the 3rd and 5th postoperative days was significant. No differences were observed among serum bilirubin levels on 3rd, 5th and 7th postoperative days. Conclusions: The bilirubin level in drain discharge increases late in the postoperative course. Therefore, bile leakage should be evaluated between the 5th and 7th postoperative days. The use of long-term drains helps protect against undiscovered collections and thus impacts postoperative course.

Original languageEnglish
Pages (from-to)1206-1210
Number of pages5
JournalHepato-Gastroenterology
Volume52
Issue number64
Publication statusPublished - Jul 2005

Keywords

  • Cholangiocellular carcinoma
  • Hepatocellular carcinoma
  • Liver cirrhosis
  • Liver metastases
  • Liver neoplasms
  • Liver neoplasms surgery

ASJC Scopus subject areas

  • Gastroenterology

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