Introduction: Before 1980 patients with symptomatic intraabdominal collections (SIAC) after hepatectomy required surgical drainage. Image guided percutaneous drainage has improved in the last two decades allowing nonsurgical management. We sought to determine the utility of percutaneous drainage in the management of patients with SIAC and analyze factors potentially associated with SIAC and biliary fistula.Patients and Methods: From a prospective database 672 patients who underwent hepatic resection between 2004 to 2006 were identified. Patients requiring drainage for SIAC were recorded and outcome after drainage was analyzed. Patient demographics, laboratory reports, intraoperative data and their association with SIAC and biliary fistula were investigated using chi-square and t-tests as well as multiple logistic regression.Results: Six hundred seventy-two underwent hepatic resection from 2004-2006; 48(7.1%) developed SIAC; 16 (33%) seroma/hematomas, 22 (46%) biliary fistulas and 10 (21%) abscesses. All patients underwent percutaneous drainage only. A small subhepatic collection was not possible to drain in one patient; however the patient’s symptoms resolved without drainage. The clinical manifestations of SIAC were: fever (77%), abdominal pain (27%), and nausea/vomiting (12%). 11(22%) patients required two drainage procedures to manage the same collection. No perioperative deaths could be directly attributed to SIAC or percutaneous drainage. On multivariate analysis, a concomitant bilioenteric anastomosis, HAIP placement and right or extended right hepatic hepatectomy were independently associated with SIAC (p<0.05). On univariate analysis, older age, lower pre-operative albumin, longer operative time, bilioenteric anastomosis and right or extended right hepatic lobectomy were associated with biliary fistula. All factors including temperature, white blood cell count, estimated blood loss, Pringle and operative time were similar between patients with infected SIAC compared to those with non infected SIAC. Conclusion: SIAC are uncommon after hepatectomy and effectively managed with percutaneous drainage. One third of patients with SIAC have non-infected/non-bilious collections and these are not easily discerned from infected SIAC based on standard clinical factors. SIAC are most likely to develop after right or extended right hepatic lobectomy, bilioenteric anastomosis and with HAIP placement.