Postoperative Abscesses in the Liver Resection Plane in Patients with a History of Biliary Tract Treatments: A Multicenter Cohort Study

Iida, Hiroya; Shinkawa, Hiroji; Kosaka, Hisashi; Ueno, Masaki; Mori, Haruki; Komeda, Koji; Yasuda, Satoshi; Kinoshita, Masahiko; Hayami, Shinya; Tani, Masaji; Kaibori, Masaki; Kubo, Shoji

doi:10.31557/APJCP.2026.27.6.2043

Postoperative Abscesses in the Liver Resection Plane in Patients with a History of Biliary Tract Treatments: A Multicenter Cohort Study

Document Type : Research Articles

Authors

¹ Department of Surgery, Shiga University of Medical Science, Shiga, Japan.

² Department of Surgery, Nishi-Kyoto Hospital, Kyoto, Japan.

³ Department of Hepato-Biliary-Pancreatic Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.

⁴ Department of Liver Surgery, Kansai Medical University, Osaka, Japan.

⁵ Second Department of Surgery, Wakayama Medical University, Wakayama, Japan.

⁶ Department of General and Gastroenterological Surgery, Osaka Medical and Pharmaceutical University, Osaka, Japan.

⁷ Department of Surgery, Nara Medical University, Nara, Japan.

⁸ Health Education Course, Department of Education, Shitennoji University, Osaka, Japan.

10.31557/APJCP.2026.27.6.2043

Abstract

Objective: The effect of previous biliary reconstruction (BR) or endoscopic sphincterotomy (EST) on post-hepatectomy bile leakage and abscess formation remains controversial. This study aimed to investigate the incidence, clinical findings, and risk factors of postoperative abscesses in the liver resection plane in patients with such histories. Methods: This multicenter retrospective study included 5,742 patients who underwent liver resection between 2011 and 2020 (38 with a history of BR, 44 with EST, and 5,660 with no history of biliary treatment). The incidence, clinical characteristics, and risk factors for abscess formation, as well as factors associated with prolonged healing duration (≥45 days), were analyzed. Results: Abscess formation was significantly more frequent in the BR (47.4%) and EST (25.0%) groups than in the non-BR/non-EST group (3.5%). Bile leakage was identified as an independent risk factor for abscess formation. Bile leakage and mixed infection both significantly more frequent in the BR group than in the non-BR/non-EST group were independent risk factors for prolonged healing duration. Conclusion: Patients with a history of BR or EST are at a higher risk of postoperative abscess formation in the liver resection plane. Bile leakage plays a critical role in both abscess development and prolonged healing.

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