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HPB Surgery
Volume 2012 (2012), Article ID 425435, 3 pages
http://dx.doi.org/10.1155/2012/425435
Clinical Study

Evaluation of the White Test for the Intraoperative Detection of Bile Leakage

1Department of Surgery, Rajavithi Hospital, Bangkok 10400, Thailand
2College of Medicine, Rangsit University, Bangkok 10400, Thailand

Received 22 December 2011; Revised 31 January 2012; Accepted 2 February 2012

Academic Editor: Vito R. Cicinnati

Copyright © 2012 Kawin Leelawat et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We assess whether the White test is better than the conventional bile leakage test for the intraoperative detection of bile leakage in hepatectomized patients. This study included 30 patients who received elective liver resection. Both the conventional bile leakage test (injecting an isotonic sodium chloride solution through the cystic duct) and the White test (injecting a fat emulsion solution through the cystic duct) were carried out in the same patients. The detection of bile leakage was compared between the conventional method and the White test. A bile leak was demonstrated in 8 patients (26.7%) by the conventional method and in 19 patients (63.3%) by the White test. In addition, the White test detected a significantly higher number of bile leakage sites compared with the conventional method (Wilcoxon signed-rank test; 𝑃 < 0 . 0 0 1 ). The White test is better than the conventional test for the intraoperative detection of bile leakage. Based on our study, we recommend that surgeons investigating bile leakage sites during liver resections should use the White test instead of the conventional bile leakage test.