title: The utility of 5-aminolevulinic acid-mediated photodynamic diagnosis in the detection of intraoperative bile leakage.
abstract: OBJECTIVE
  The purpose of this retrospective study was to evaluate the utility of the new intraoperative bile leakage test as a preventive measure of postoperative bile leakage.
  
  
  METHODS
  737 patients were retrospectively analyzed with respect to the management of intra- and post-operative bile leakage.
  
  
  RESULTS
  Nine (8.3%) of 109 patients evaluated using conventional white light fluorescent imaging were recognized as having intra-operative bile leakage. However, performance of 5-aminolevulinic acid (5-ALA)-mediated PDD detected bile leakage intraoperatively not only in these 9 patients, but also in an additional 6 patients, such that 'red fluorescence' at the cut surface of the liver, was visualized in a total of 15 patients. The postoperative courses of most patients were uneventful, and postoperative bile leakages occurred in only one (0.9%) patient.
  
  
  CONCLUSIONS
  5-ALA fluorescence imaging may be needed to prevent postoperative bile leakage in patients at high risk for this surgical complication after hepatic resection.
authors.affiliation: Department of General and Gastroenterological Surgery, Osaka Medical College Hospital, Takatsuki City, Osaka, Japan. Electronic address: sur129@poh.osaka-med.ac.jp.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Inoue
authors.affiliation: Department of General and Gastroenterological Surgery, Osaka Medical College Hospital, Takatsuki City, Osaka, Japan. Electronic address: sur141@poh.osaka-med.ac.jp.
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Imai
authors.affiliation: Department of General and Gastroenterological Surgery, Osaka Medical College Hospital, Takatsuki City, Osaka, Japan. Electronic address: sur149@poh.osaka-med.ac.jp.
authors.forename: Kensuke
authors.initials: K
authors.lastname: Fujii
authors.affiliation: Department of General and Gastroenterological Surgery, Osaka Medical College Hospital, Takatsuki City, Osaka, Japan. Electronic address: sur122@poh.osaka-med.ac.jp.
authors.forename: Fumitoshi
authors.initials: F
authors.lastname: Hirokawa
authors.affiliation: Department of General and Gastroenterological Surgery, Osaka Medical College Hospital, Takatsuki City, Osaka, Japan. Electronic address: sur083@poh.osaka-med.ac.jp.
authors.forename: Michihiro
authors.initials: M
authors.lastname: Hayashi
authors.affiliation: Department of General and Gastroenterological Surgery, Osaka Medical College Hospital, Takatsuki City, Osaka, Japan. Electronic address: uchi@poh.osaka-med.ac.jp.
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Uchiyama
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000622:Aminolevulinic Acid; D057868:Anastomotic Leak / Q000000981:diagnostic imaging* / Q000209:etiology; D001646:Bile; D002648:Child; D002675:Child, Preschool; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007430:Intraoperative Care; D007431:Intraoperative Complications / Q000000981:diagnostic imaging* / Q000209:etiology; D008113:Liver Neoplasms / Q000601:surgery; D008297:Male; D008875:Middle Aged; D061848:Optical Imaging; D017319:Photosensitizing Agents; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D017319:Photosensitizing Agents; D000622:Aminolevulinic Acid
keywords: 5-Aminolevulinic acid-mediated photodynamic diagnosis; Bile leakage; Hepatic resection