Analyzing risk factors for early postoperative bile leakage based on Clavien classification in bile duct stones

•We utilized Clavien–Dindo Classification System (CCS) to grade bile leakage.•We identified independent risk factors for bile leakage with varying degrees of severity in bile duct stones.•Risk factors for mild and severe postoperative bile leakage, in bile duct stones, were different.

ObjectivesTo identify the risk factors of bile leakage, with different severity, based on Clavien–Dindo complication classification system.Materials and methodsA retrospective analysis of 943 eligible patients was performed. Sixty-eight patients, with bile leakage, were divided into 2 groups: mild bile leakage (grades I, II, n = 41) and severe bile leakage (grades III, IV, V, n = 27). Twenty-five potential factors were analyzed, by multivariate regression analyses, to identify independent risk factors of bile leakage.ResultsThe independent risk factors of bile leakage, for the entire cohort, included attacks of acute cholangitis within 1 month, associated biliary-enteric anastomosis (BEA), associated hepatectomy and previous biliary surgery. The independent risk factors for patients with mild bile leakage were attacks of acute cholangitis within 1 month, associated hepatectomy, and a history of previous biliary surgery. Similarly, the independent risk factors for patients with severe bile leakage were attacks of acute cholangitis within 1 month, associated hepatectomy, and associated BEA.ConclusionsRisk factors for mild and severe postoperative bile leakage, in bile duct stones, were different.