Comprehensive review of post-liver resection surgical complications and a new universal classification and grading system

Table 3 Grading system and representative management strategies for bile leakage

Grades	Definition	Management strategies
Grade A	No change in the patient’s clinical management strategy required or manageable with simple drainage	Drainage within 7 d Antibiotic administration
Grade B	Manageable with interventional procedures	Drainage for 7 or more day, ethanol injection, fibrin paste injection, single ENBD, single EBD, single PTBD, PTPE, TAE
Grade C	Cases involving pneumoperitoneum, inflammation, multiple organ failure, or reoperation	Complicated IVR (combinations with any Grade Bs) Reoperation

ENBD: Endoscopic nasobiliary drainage; EBD: Andoscopic biliary drainage; PTBD: Percutaneous transhepatic biliary drainage; PTPE: Percutaneous transcatheter portal embolization; TAE: Transcatheter arterial embolization; IVR: Interventional radiology.