Does the placement of a cystic duct tube after a hepatic resection help reduce the incidence of post‐operative bile leak?

Abstract Background In this retrospective study, the effects of cystic duct (C) tube use on the incidence of post‐hepatectomy bile leak were assessed. Methods The subjects were 550 patients who underwent a hepatectomy during 1990–2011, with ( n = 83) and without ( n = 467) C tube drainage. The use of a C tube was based on the surgeon's choice. Results Bile leakage was observed in 44 (8%) patients, and its incidence post‐operatively correlated with intrahepatic cholangiocarcinoma, parenchymal transection with forceps fracture and tie, a major hepatectomy, prolonged surgery and excessive blood loss ( P < 0.050) but not with the use of a C tube. The incidence of an intra‐abdominal infection was higher and the hospital stay was longer in the leak (49 days) than non‐leak group (21 days, P < 0.001). ISGLS grade B and C bile leak post‐hemi‐hepatectomy and extended‐hepatectomy were more frequent in the non‐C than C tube group ( P = 0.016). The duration of hospitalization was not different between the two groups; however, 7 patients in the non‐C tube group had prolonged hospitalization (> 60 days) compared with none in the C tube group ( P = 0.454). Conclusion The usefulness of the C tube in preventing post‐hepatectomy bile leak could not be confirmed; however, both bile leak requiring clinical management and long hospitalization after a major hepatectomy could be reduced with C tube use.