White gauze test

a novel technique in preventing post-hepatectomy bile leak

K. Yugasaravanan, C. A. Affirul, Zamri Zuhdi, Azlanudin Azman, J. J. Bong

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

BACKGROUND: Post-hepatectomy bile leak may lead to undesired morbidity. Multiple methods have been employed to identify this leak but can be inconclusive and taxing. This novel white gauze test is a simple and reliable method.

MATERIALS AND METHODS: This is a prospective study performed from January 2010 until March 2011. All open hepatic resection were included. Dry white gauze is compressed onto the transected surface and observed for bile staining. The leaking duct is repaired immediately upon detection. The process is repeated until negative. Drain was removed on postoperative day-5. Post-operative bile leak is defined as: 1. Bilirubin concentration of the drain fluid is 3 times or higher than serum; 2. Presence of intra-abdominal bile collection on imaging and upon drainage; 3. Bile leak demonstrated on postoperative cholangiography.

RESULTS: 42 patients were recruited. Seven (16.7%) patients were cirrhotic with Child-Pugh A. White gauze test were positive for intra-operative bile leaks in 29 patients (70%), which were primarily repaired. As a result, there was no postoperative bile leak in this series. One mortality was detected in this series due to postoperative pancreatic fistula and multi organ failure.

CONCLUSIONS: The White Gauze Test is a useful method for the prevention of bile leakage after hepatic resection. It is safe, quick and cheap.

Original languageEnglish
Pages (from-to)e102-e104
JournalLa Clinica terapeutica
Volume166
Issue number2
DOIs
Publication statusPublished - 1 Jan 2015
Externally publishedYes

Fingerprint

Hepatectomy
Bile
Pancreatic Fistula
Cholangiography
Liver
Bilirubin
Drainage
Prospective Studies
Staining and Labeling
Morbidity
Mortality
Serum

Keywords

  • Bile leak
  • Complications
  • Hepatectomy
  • Liver resection
  • Post-operative

ASJC Scopus subject areas

  • Medicine(all)

Cite this

White gauze test : a novel technique in preventing post-hepatectomy bile leak. / Yugasaravanan, K.; Affirul, C. A.; Zuhdi, Zamri; Azman, Azlanudin; Bong, J. J.

In: La Clinica terapeutica, Vol. 166, No. 2, 01.01.2015, p. e102-e104.

Research output: Contribution to journalArticle

Yugasaravanan, K. ; Affirul, C. A. ; Zuhdi, Zamri ; Azman, Azlanudin ; Bong, J. J. / White gauze test : a novel technique in preventing post-hepatectomy bile leak. In: La Clinica terapeutica. 2015 ; Vol. 166, No. 2. pp. e102-e104.
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