Yoshihiro Inoue1, Yoshiro Imai2, Kensuke Fujii3, Fumitoshi Hirokawa4, Michihiro Hayashi5, Kazuhisa Uchiyama6. 1. Department of General and Gastroenterological Surgery, Osaka Medical College Hospital, Takatsuki City, Osaka, Japan. Electronic address: sur129@poh.osaka-med.ac.jp. 2. Department of General and Gastroenterological Surgery, Osaka Medical College Hospital, Takatsuki City, Osaka, Japan. Electronic address: sur141@poh.osaka-med.ac.jp. 3. Department of General and Gastroenterological Surgery, Osaka Medical College Hospital, Takatsuki City, Osaka, Japan. Electronic address: sur149@poh.osaka-med.ac.jp. 4. Department of General and Gastroenterological Surgery, Osaka Medical College Hospital, Takatsuki City, Osaka, Japan. Electronic address: sur122@poh.osaka-med.ac.jp. 5. Department of General and Gastroenterological Surgery, Osaka Medical College Hospital, Takatsuki City, Osaka, Japan. Electronic address: sur083@poh.osaka-med.ac.jp. 6. Department of General and Gastroenterological Surgery, Osaka Medical College Hospital, Takatsuki City, Osaka, Japan. Electronic address: uchi@poh.osaka-med.ac.jp.
Abstract
PURPOSE: The purpose of this retrospective study was to evaluate the utility of the new intraoperative bile leakage test as a preventive measure of postoperative bile leakage. METHOD: 737 patients were retrospectively analyzed with respect to the management of intra- and post-operative bile leakage. RESULTS: Nine (8.3%) of 109 patients evaluated using conventional white light fluorescent imaging were recognized as having intra-operative bile leakage. However, performance of 5-aminolevulinic acid (5-ALA)-mediated PDD detected bile leakage intraoperatively not only in these 9 patients, but also in an additional 6 patients, such that 'red fluorescence' at the cut surface of the liver, was visualized in a total of 15 patients. The postoperative courses of most patients were uneventful, and postoperative bile leakages occurred in only one (0.9%) patient. CONCLUSION: 5-ALA fluorescence imaging may be needed to prevent postoperative bile leakage in patients at high risk for this surgical complication after hepatic resection.
PURPOSE: The purpose of this retrospective study was to evaluate the utility of the new intraoperative bile leakage test as a preventive measure of postoperative bile leakage. METHOD: 737 patients were retrospectively analyzed with respect to the management of intra- and post-operative bile leakage. RESULTS: Nine (8.3%) of 109 patients evaluated using conventional white light fluorescent imaging were recognized as having intra-operative bile leakage. However, performance of 5-aminolevulinic acid (5-ALA)-mediated PDD detected bile leakage intraoperatively not only in these 9 patients, but also in an additional 6 patients, such that 'red fluorescence' at the cut surface of the liver, was visualized in a total of 15 patients. The postoperative courses of most patients were uneventful, and postoperative bile leakages occurred in only one (0.9%) patient. CONCLUSION:5-ALA fluorescence imaging may be needed to prevent postoperative bile leakage in patients at high risk for this surgical complication after hepatic resection.