TY  - JOUR
A1  - Linke, Richard
A1  - Ulrich, Frank
A1  - Bechstein, Wolf Otto
A1  - Schnitzbauer, Andreas
T1  - The White-test helps to reduce biliary leakage in liver resection: a systematic review and meta-analysis
T2  - Annals of Hepatology
N2  - Background. Bile leakage testing may help to detect and reduce the incidence of biliary leakage after hepatic resection. This review was performed to investigate the value of the White-test in identifying intraoperative biliary leakage and avoiding postoperative leakage.
Material and methods. A systematic review and meta-analysis was performed. Two researchers performed literature research. Primary outcome measure was the incidence of post-hepatectomy biliary leakage; secondary outcome measure was the ability of detecting intraoperative biliary leakage with the help of the White-test.
Results. A total of 4 publications (including original data from our center) were included in the analysis. Evidence levels of the included studies had medium quality of 2b (individual cohort studies including low quality randomized controlled trials). Use of the White-test led to a significant reduction of post-operative biliary leakage [OR: 0.3 (95% CI: 0.14, 0.63), p = 0.002] and led to a significant higher intraoperative detection of biliary leakages [OR: 0.03 (95%CI: 0.02, 0.07), p < 0.00001].
Conclusion. Existing evidence implicates the use of the White-test after hepatic resection to identify bile leaks intraoperatively and thus reduce incidence of post-operative biliary leakage. 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.
KW  - Diagnostic dye
KW  - Intraoperative test
KW  - Lipid solution
Y1  - 2019
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/77153
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-771537
SN  - 1665-2681
VL  - 14
IS  - 2
SP  - 161
EP  - 167
PB  - Mexican Association of Hepatology
CY  - México
ER  -