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William C. Chapman, MD
Nashville, Tenn

Arch Surg. 2000;135:1400.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Biliary leakage, an uncommon complication following liver resection, can cause septic complications. When leaks occur, closed suction drains left at the time of abdominal closure or drains placed percutaneously usually allow spontaneous resolution within days or weeks. Major biliary fistulas, though rare, may require further intervention that includes endoscopic retrograde cholangiopancreatography and stent placement. Thus, any technique that reduces this complication is of interest to surgeons performing liver resection.

In the article by Ijichi et al, the authors use a biliary saline infusion test following hepatic resection along with visual inspection to identify leakage sites from the cut surface and compare this method with visual inspection alone. While the technique identified 1 to 6 sites of leakage per patient that were then oversewn, it did not reduce the incidence of biliary leakage compared with visual inspection alone. One would have to conclude that biliary leakage identified . . . [Full Text of this Article]

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Randomized Trial of the Usefulness of a Bile Leakage Test During Hepatic Resection
Masayoshi Ijichi, Tadatoshi Takayama, Hiroyuki Toyoda, Keiji Sano, Keiichi Kubota, and Masatoshi Makuuchi
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