Intraoperative “white test” for bile leak detection during liver resection: a video vignette

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Publication Details

Journal
Daehan nae'si'gyeong bog'gang'gyeong oe'gwa haghoeji/Journal of minimally invasive surgery
Published
2026-09-15
DOI
https://doi.org/10.7602/jmis.2026.29.3.167
Primary Topic
Gallbladder and Bile Duct Disorders
Type
article
Field-Weighted Citation Impact
0.00
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article

Intraoperative “white test” for bile leak detection during liver resection: a video vignette

Nicola Colucci, Graziano Oldani, M. Bleszynski, Peter TW Kim et al.
Daehan nae'si'gyeong bog'gang'gyeong oe'gwa haghoeji/Journal of minimally invasive surgery
Gallbladder and Bile Duct Disorders
article

Intraoperative “white test” for bile leak detection during liver resection: a video vignette

Nicola Colucci, Graziano Oldani, M. Bleszynski, Peter TW Kim, Anastasios D. Giannou, Muhammad Uzair Khalid, Maja Segedi, Stéphanie Chartier-Plante
article en

Abstract

Postoperative bile leak remains a significant source of morbidity after liver resection, especially following major or complex hepatectomies. The intraoperative "white test" is a simple technique to improve detection of bile leaks through retrograde injection of a lipid emulsion into the biliary tree, enabling direct visualization of open bile ducts on the transection surface. We report its use during a minimally invasive extended left hepatectomy for colorectal liver metastases. After parenchymal transection, the white test was performed via the cystic duct stump using Intralipid (Fresenius Kabi), identifying a focal bile leak near the left pedicle stapling line, which was promptly secured. The postoperative course was uneventful, with no bile leak or liver-related complications. Follow-up imaging showed no recurrence or biloma. This case highlights the technical simplicity and high visual contrast of the white test for intraoperative bile leak detection, with the accompanying video offering added educational value beyond a written description.

Daehan nae'si'gyeong bog'gang'gyeong oe'gwa haghoeji/Journal of minimally invasive surgeryVol. 29(3)
University of British Columbia (CA), Vancouver General Hospital (CA)
Openalex Percentile: Top 12%
Gallbladder and Bile Duct Disorders
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