Skipenko Oleg G, Bedzhanyan Arkady L, Chardarov Nikita K, Ermak Irina B, Ermak Andrew D, Rummo Oleg O, Fedoruk Dzmitry A, Kotenko Oleg G, Kazaryan Airazat M
Department of Hepatopancreatobiliary Surgery, Petrovsky National Research Center of Surgery, Moscow, Russia.
Department of Colorectal Surgery, Petrovsky National Research Centre of Surgery, Moscow, Russia.
Updates Surg. 2025 Apr 30. doi: 10.1007/s13304-025-02210-4.
Bile leakage is a common complication after liver resection. It often requires repeated interventions or surgery and prolongs the patient's recovery. The aim of the study was to assess the effectiveness of the leakage test with fat emulsion (the White Test) in preventing postoperative biliary complications. A multicenter (3 hospitals) randomized controlled trial was performed from February 2011 to May 2016. The trial involved only the patients scheduled for major hepatectomies. After liver transection and control of biliary tree leak-proofness, the patients were randomized into two groups-with and without applying the White Test. A comparative assessment of all the White Test participants was conducted. Forty-three patients formed the study group, and 36 patients were included in the control group. The White Test revealed sites of bile leakage (the positive White Test) in 37.2% (16/43) of the patients in the study group. These leakage sites were sealed intraoperatively. One of those patients (6.2%; 1/16) still developed bile leakage after surgery. Bile leakage was still observed in 7.4% (2/27) of patients after the negative White test. The incidence of postoperatively revealed bile leakage in the study and control groups did not have a statistically significant difference: 7% (3/43) and 8.3% (3/36), respectively. All bile leaks were grade B. This study demonstrated that the White Test did not provide any benefit in preventing postoperative bile leakage; therefore, other methods, such as ICG, should be further investigated.
胆漏是肝切除术后常见的并发症。它常常需要反复干预或手术，延长了患者的康复时间。本研究的目的是评估脂肪乳剂渗漏试验（怀特试验）在预防术后胆道并发症方面的有效性。2011年2月至2016年5月进行了一项多中心（3家医院）随机对照试验。该试验仅纳入计划进行大肝切除术的患者。在肝离断并检查胆管树的防漏情况后，将患者随机分为两组——应用怀特试验组和未应用怀特试验组。对所有参与怀特试验的患者进行了对比评估。43例患者组成研究组，36例患者纳入对照组。怀特试验在研究组37.2%（16/43）的患者中发现了胆漏部位（怀特试验阳性）。这些渗漏部位在术中进行了封闭。其中1例患者（6.2%；1/16）术后仍发生了胆漏。怀特试验阴性的患者中仍有7.4%（2/27）观察到胆漏。研究组和对照组术后发现胆漏的发生率无统计学显著差异：分别为7%（3/43）和8.3%（3/36）。所有胆漏均为B级。本研究表明，怀特试验在预防术后胆漏方面没有任何益处；因此，应进一步研究其他方法，如吲哚菁绿。
