Postoperative bile leaks did not affect the survival of hepatoblastoma but were associated with long-term complications: retrospective case-control study

Purpose: This study assessed the long-term impact of bile leak complications on the pediatric hepatoblastoma (HB) patients post-surgery. With HB predominantly affecting children under five, the increased survival rates necessitate a focus on the post-surgical complications, particularly concerning the effects of bile leaks. Methods: A retrospective analysis was conducted on patients treated for HB at our institution from 1980 to 2022. The diagnosis, operative procedure, complications, mortality, and prognosis were retrospectively analyzed to examine the incidence and long-term effects of surgical complications, especially bile leaks. The study involved detailed statistical analyses, including assessments of the Kaplan–Meier survival rates and comparisons of complication incidences using log-rank tests. Results: Of the 53 reviewed cases, 43 were analyzed. Bile leaks occurred in 20% of liver resection patients, markedly impacting their long-term QOL through severe complications like gastric obstructions, portal vein occlusion, and bile duct stricture. Nonetheless, the overall 5-year survival rate was high at 87.8%. The prognosis did not differ significantly between patients with and without short-term complications. Conclusion: In patients with HB, postoperative bile leaks occasionally lead to long-term complications. Even if the complications do not influence their prognosis, surgeons must be alert for the possibility of long-term complications after surgery for HB.