Low preoperative serum total bilirubin level is a risk factor for intraoperative blood loss in the laparoscopic hepatectomy ---a retrospective study

Abstract Background Reduction of Intraoperative blood loss (IBL) is necessary for laparoscopic hepatectomy (LH). However, the risk factors before liver resection for IBL in LH is poorly understood. The research aimed to analyze the risk factors before liver resection for IBL in LH. Methods The data of consecutive patients who underwent LH for hepatocellular carcinoma from 2021 to 2022, were retrieved retrospectively. The patients were divided into two groups: the group A was for those with an IBL less than 250 mL (Group A, IBL༜250ml), and the group B was for those with an IBL more than 250 mL (Group B, IBL ≥ 250ml). Results We analyzed 246 patients who underwent LH. Median IBL was 250 (IQR: 100–500) ml in our research. Tumor size ≥ 3cm contributed to a higher level of IBL with Odds ratio of 2.496(95% CI 1.422–4.381, p = 0.001). High preoperative total bilirubin levels may be a protective factor for IBL ≥ 250ml and Odds ratio was 0.438༈95% CI 0.258–0.743, p = 0.002༉and a dose-response relationship was observed. In other words, low preoperative total bilirubin levels may be a risk factor for IBL ≥ 250ml. After correcting for other variables of characteristics, their statistical significance remained unchanged. The incidence of postoperative complications was 16.3%. The incidence of postoperative complications was significantly higher in Group B compared to Group A (21.8 vs. 10.7%, p = 0.018). Conclusions Increased IBL (≥ 250 ml) may adversely impact the short-term outcomes. In addition to tumor size, low preoperative serum total bilirubin level may be a risk factor for blood loss in LH.