Analysis of risk factors for bile leakage after laparoscopic exploration and primary suture of common bile duct

Table 1 Data summary and analysis, n (%)

Characteristic		Overall	No bile leakage occurs	Gallbladder leakage occurs
Gallstones-multiple	No	90 (84.91)	78 (100)	12 (100)
	Yes	16 (15.09)	16 (0)	0 (0)
Gallstones-micro stones	No	78 (73.58)	69 (75)	9 (75)
	Yes	28 (26.42)	25 (25)	3 (25)
Gallstones-post laparoscopic common surgery	No	93 (87.74)	86 (58.33)	7 (58.33)
	Yes	13 (12.26)	8 (41.67)	5 (41.67)
Common bile duct stones-single	No	67 (63.21)	60 (58.33)	7 (58.33)
	Yes	39 (36.79)	34 (41.67)	5 (41.67)
Common bile duct stones	No	52 (49.06)	47 (41.67)	5 (41.67)
	Yes	54 (50.94)	47 (58.33)	7 (58.33)
Common bile duct stones-micro stones	No	37 (34.91)	34 (36.17)	3 (25)
	Yes	69 (65.09)	60 (63.83)	9 (75)
Common bile duct stones-cellulose	No	72 (67.92)	69 (73.40)	3 (25)
	Yes	34 (32.08)	25 (26.60)	9 (75)
Common bile duct stones	No	103 (97.17)	91 (100)	12 (100)
	Yes	3 (2.83)	3 (0)	0 (0)
CBD	5-6	7 (6.6)	6 (8.33)	1 (8.33)
	6-7	17 (16.04)	15 (16.67)	2 (16.67)
	7-8	16 (15.09)	15 (8.33)	1 (8.33)
	8-9	18 (16.98)	15 (25)	3 (25)
	> 9	48 (45.28)	43 (41.67)	5 (41.67)
Factors, mean ± SD
WBC		7.35 ± 3.36	7.57 ± 3.39	5.64 ± 2.56
HB		132.1 ± 16.42	132.23 ± 17.15	131.08 ± 9.23
CRP		22.42 ± 46.68	23.91 ± 48.38	10.76 ± 29.06
CA199		99.06 ± 361.33	72.21 ± 283.09	233.27 ± 628.95
Total bilirubin		41.33 ± 36.58	43.91 ± 37.93	21.13 ± 10.4
Directly increase the proportion		2.64 ± 3.06	19.48 ± 21.73	7.04 ± 6.6
Indirect increase ratio		1.52 ± 1.13	24.43 ± 17.75	14.09 ± 4.93
Straight to straight ratio		0.82 ± 0.45	0.87 ± 0.44	0.45 ± 0.28
Albumin		43.48 ± 5.09	1.6 ± 1.18	0.93 ± 0.32
ALT/AST		0.76 ± 0.52	0.94 ± 0.98	0.36 ± 0.07
GGT		308.09 ± 289.23	43.52 ± 5.19	43.16 ± 4.39
ALP		166.2 ± 133.37	223.04 ± 241.17	73.29 ± 90.76
TBA		33.2 ± 54.3	130.9 ± 161.17	41.76 ± 39.36
Operative time		89.42 ± 28.76	0.75 ± 0.53	0.77 ± 0.4

CBD: Common bile duct diameter; WBC: White blood cell; HB: Hemoglobin; CRP: C-reactive protein; CA199: Carbohydrate antigen 199; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; GGT: γ-glutamyl transpeptidase; ALP: Alkaline phosphatase; TBA: Total bile acid.

Table 2 Single factor logistic regression screening for risk factors

Factors	Coefficient	Z value	P value
Incidence	-0.9614	-1.5464	0.1220
History of diabetes	1.5041	1.6209	0.1050
History of hypertension	1.1436	1.8248	0.0680
Gallstones-multiple	-16.6943	-0.0102	0.9918
Gallstones-micro stones	-0.0834	-0.1180	0.9060
Common bile duct stones-single	0.2315	0.3712	0.7105
Common bile duct stones	0.3365	0.5420	0.5878
Common bile duct stones-micro stones	0.5306	0.7576	0.4487
Common bile duct stones-cellulose	2.1138	2.9930	0.0028
Common bile duct stones	-14.5401	-0.0105	0.9916
CBD	-0.2231	-0.1695	0.8654
WBC	-0.2557	-1.8175	0.0691
HB	-0.0043	-0.2297	0.8183
CRP	-0.0105	-0.8830	0.3772
CA199	0.0009	1.1705	0.2418
Total bilirubin	-0.0506	-2.0312	0.0422
Direct/indirect bilirubin	-7.0321	-2.8225	0.0048
Albumin	0.0000	0.0000	1.0000
ALT/AST	0.0731	0.1259	0.8998
GGT	0.0000	0.0000	1.0000
ALP	-0.0065	-1.3364	0.1814
TBA	-0.0024	-0.3707	0.7109
Operative time	0.0157	1.7035	0.0885
Suture method	0.3221	0.4915	0.6231

CBD: Common bile duct diameter; WBC: White blood cell; HB: Hemoglobin; CRP: C-reactive protein; CA199: Carbohydrate antigen 199; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; GGT: γ-glutamyl transpeptidase; ALP: Alkaline phosphatase; TBA: Total bile acid.

Table 3 Multivariate logistic regression analysis

Factor	Partial regression coefficient	Error	Z value	P value	OR	95%CI
Common bile duct stones-cellulose	1.97008	0.77372	2.546	0.0109	7.171	1.705-38.400
Total bilirubin	-0.03732	0.02841	-1.314	0.189	0.963	0.903-1.010
Direct/indirect bilirubin	-5.60348	2.43206	-2.304	0.0212	0.004	0.000-0.154

OR: Odds ratio; CI: Confidence interval.

Table 4 The impact of bile leakage on extubation time, discharge time, and total hospitalization costs, mean ± SD

Factors	No bile leakage occurs	Gallbladder leakage occurs	Z value	P value
Pull out time	3.61 ± 1.25	5.33 ± 2.81	-2.627	0.009
Discharge time	5.77 ± 1.44	8.67 ± 6.49	-2.105	0.035
Total hospitalization expenses	15913.7 ± 3246.7	17249.28 ± 4344.86	-0.648	0.517