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David W. McFadden, MD

Arch Surg. 2008;143(4):404.

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

Nadalin and 8 coauthors from Essen, Germany, have described an intraoperative technique to localize bile leakage from the hepatic parenchymal surface using a cystic duct injection of fat emulsion, 5%. This technique, previously described to detect urinary leakage after renal transplantation, has allowed the authors to identify bile leakages in 74% of their patients. Once identified and sutured, a postoperative biliary leak rate of 5.1% was reported. This incidence is lower than the authors' previously published leakage rate of 8% in more than 1600 hepatic resections, though a statistical comparison is not included.

Bile leakages after liver resection occur in up to 36% of patients and contribute substantially to morbidity and mortality. Therefore, technical diligence is required intraooperatively to minimize their occurrence. Biliary injection of dyes, such as methylene blue, have been recommended, but have the drawback of staining surrounding tissues, making precise localization or identification . . . [Full Text of this Article]

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RELATED ARTICLE

The White Test: A New Dye Test for Intraoperative Detection of Bile Leakage During Major Liver Resection
Silvio Nadalin, Jun Li, Hauke Lang, Georgios C. Sotiropoulos, Randolph Schaffer, Arnold Radtke, Fuat Saner, Christoph E. Broelsch, and Massimo Malagó
Arch Surg. 2008;143(4):402-404.
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