Effectiveness of White test versus conventional saline test in minimizing biliary leak in partial liver resection in living donor liver transplant

Abstract

Abstract Background Intra-operative bile leakage testing is very important in partial liver resection in living donor liver transplant as it allows detection of bile leaking points on the cut surface and decreases postoperative bile leak which is one of the most dreadful complication following liver transplant surgery. In this study we tried to assess the Effectiveness of White test versus conventional saline test in minimizing biliary leak in partial liver resection in living donor liver transplant. Objective In this study, we assess whether the White test is better than the conventional saline test for the intraoperative detection of biliary leakage in patients who will undergo partial liver resection as living donor liver transplant. Methodology In this study, we assess whether the White test is better than the conventional saline test for the intraoperative detection of bile leakage in patients who underwent partial liver resection as a living donor liver transplant. This study included 60 patients who received partial liver resection as a living donor liver transplant. The conventional saline test (injecting an isotonic sodium chloride solution through the cystic duct) was carried out in 30 patients and the White test (injecting a fat emulsion solution through the cystic duct) was carried out in 30 patients Results Incidence of postoperative bile leakage was compared between the conventional method and the White test. Bile leakage occurred in 8 patients (26.7%) in the conventional method group and in 2 patients (6.7%) in the White test group. In addition, the White test detected intraoperative a significantly higher number of bile leakage sites compared with the conventional method. The White test is better than the conventional test for the intraoperative detection of bile leakage. Conclusion Based on our study, we recommend that surgeons investigating bile leakage sites during liver resections should use the White test instead of the conventional saline test.