title: Intraoperative application of "white test" to reduce postoperative bile leak after major liver resection: results of a prospective cohort study in 137 patients.
abstract: OBJECTIVE
  This study aimed to prove the clinical validation of the recently developed bile leakage test, "white test" (WT), in major liver resection.
  
  
  METHODS
  From June 2005 to June 2007, the study was carried out in a prospective consecutive fashion, including 74 patients without bile leakage test as the control group while 63 patients undergoing white test as the study group. The incidences of bile leakage within the 30th postoperative day in both groups were compared.
  
  
  RESULTS
  Postoperative bile leakage was found in 22.9% patients in the control group and in 5.3% patients in the WT group, respectively (p < 0.01). In univariate analysis, not performing a white test, Klatskin tumor, biliary-enteric anastomosis, and longer operation time were associated with an increase of bile leakage. The multivariate analysis showed that not performing the WT was the only significant factor influencing the occurrence of postoperative bile leakage (p = 0.02).
  
  
  CONCLUSIONS
  The white test is a feasible and sensitive bile leakage test with no obvious disadvantages. It could be a possible standardized method to prevent bile leakage in major liver resection.
authors.affiliation: Department of General, Visceral, and Transplant Surgery, University Hospital Essen, Essen, Germany.
authors.forename: Jun
authors.initials: J
authors.lastname: Li
authors.forename: Massimo
authors.initials: M
authors.lastname: Malagó
authors.forename: Georgios C
authors.initials: GC
authors.lastname: Sotiropoulos
authors.forename: Hauke
authors.initials: H
authors.lastname: Lang
authors.forename: Randolph
authors.initials: R
authors.lastname: Schaffer
authors.forename: Andreas
authors.initials: A
authors.lastname: Paul
authors.forename: Christoph E
authors.initials: CE
authors.lastname: Broelsch
authors.forename: Silvio
authors.initials: S
authors.lastname: Nadalin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001646:Bile; D015331:Cohort Studies; D005217:Fat Emulsions, Intravenous; D005240:Feasibility Studies; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D007430:Intraoperative Care; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D011237:Predictive Value of Tests; D055815:Young Adult
chemical_list: D005217:Fat Emulsions, Intravenous