Lecture : During laparoscopic liver resection, we occasionally experienced intraoperative bile leakage (IOBL) and managed it within the restrictions of laparoscopic surgery. We investigated the impact of IOBL on postoperative outcomes and its predictive factors. We reviewed 137 patients who underwent LLR at our institute and assigned them to IOBL-positive or -negative groups. We compared clinicopathological characteristics and perioperative outcomes. Patients were further divided into four groups according to IOBL pattern, and the frequency of POBL in each was calculated. Predictors of IOBL were identified using multivariate logistic regression analysis. There were 30 and 107 patients in the IOBL-positive and -negative groups, respectively. In the IOBL-positive group, operative time and postoperative hospital stays were significantly longer (P <0.001). The frequency of POBL was significantly higher than in the IOBL-negative group (P = 0.006). The IOBL-positive group was divided into two subgroups: IOBL from the transected parenchyma (IOBL-TP, n = 18) and from the main Glissonean pedicle (IOBL-mGP, n = 12). The IOBL-negative group was divided into two subgroups: yellowish change in mGP (YC-mGP, n = 9) and no change (NC, n = 98). POBL occurred in 11% (n = 2/18) of patients with IOBL-TP, 25% (n = 3/12) of those with IOBL-mGP, 11% (n = 1/9) of those with YC-mGP, and 1% (n = 1/98) of those with NC. Age, diabetes mellitus, indocyanine green retention rate, and Glissonean approach were predictors of IOBL (P <0.05). Based on these results, we think that IOBL was relatively common during LLR and resulted in a higher incidence of POBL. Depending on the predictive factors, IOBL must be promptly identified and appropriately managed. In this lecture, we will show you some tips for controlling bile leakage during LLR.