Background : Bile leakage after hepatectomy is one of the most common post-operative complications that can lead to several complications. Reports from several centers showed different incidences of 2-30%. Risk factors for post-hepatic surgery bile leakage are still unclear. This study was to find out incidence of bile leakage in hepatobiliary tertiary center that operated around 200 cases per year and analyze its risk factor.

Methods : Medical record of 231 patients undergone hepatectomy since January 21st 2020 to December 31st 2022 were reviewed. Incidence of bile leakage was reported as percentage. The association between risk factors and post-operative bile leakage was analyzed using univariate regression.

Results : 55/231 patients (23.8%) had bile leakage, categorized as Grade A and B 14.3% and 9.5% respectively. Major hepatectomy without bile duct resection and reconstruction (BDR) had the highest incidence at 34.5%, significantly more than Major hepatectomy with BDR and Minor hepatectomy (23% and 14.7%, respectively) (p-value 0.014). Univariate analysis showed that Major hepatectomy without BDR significantly increased the risk of bile leakage compared to Minor surgery (OR 3.05, 95%CI 1.48 to 6.3). However, there was no association between BDR and bile leakage in patients undergoing Major Hepatectomy (OR 0.57, 95%CI 0.26 to 1.25).

Conclusions : Bile leakage has high incidence after liver resection especially in major hepatectomy without BDR, special care should be consider in patients with such an operation