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White-test helps to reduce incidence of biliary leakage after hepatic resection
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The use of the White-test reduced biliary leakage after liver resection, according to study findings published in Annals of Hepatology.
“The findings of this systematic review and meta-analysis of White-test application during hepatic surgery to detect biliary leakage and thus reduce the incidence of post-hepatectomy biliary leakage are relevant for a better outcome in hepatobiliary surgery,” the researchers wrote. “Biliary leakage, with reported rate of up to 30% after major hepatectomy, special indications or complicated segmentectomies and atypical resections is one of the major contributor to morbidity in hepatobiliary surgery.”
Researchers from the Frankfurt University Hospitals in Germany conducted a systematic review and meta-analysis with four studies, including data from a cohort of 125 patients who underwent a hepatectomy at Frankfurt University Hospitals, after searching various databases for randomized controlled trials that investigated using White-test for biliary leakage.
Overall, 369 patients were used in analyses; 148 used White-test and 221 did not. From the analysis, researchers found that the use of White-test reduced biliary leakage postoperatively (OR = 0.3; 95% CI, 0.14-0.63) and increased biliary leakage detection intraoperatively (OR = 0.03; 95% CI, 0.02-0.07).
“The test is easy to perform during surgery, cheap and repeatable at the surgeon’s choice,” the researchers wrote. “Therefore, cost–benefit estimation supports the use of the test during hepatic surgery.
“Existing evidence implicates the use of the White-test after hepatic resection to identify bile leaks intraoperatively and thus reduce incidence of postoperative biliary leakage,” the researchers concluded. “Nonetheless, there is a requirement for a high-quality randomized controlled trial with adequately powered sample-size to confirm findings from the above described studies and further increase evidence in this field.”
Disclosure: Relevant financial disclosures were not provided by the researchers.