The white test for intraoperative screening of bile leakage: a potential trigger factor for acute pancreatitis after liver resection—a case series
Abstract Background Acute pancreatitis after liver resection is a rare but serious complication, and few cases have been described in the literature. Extended lymphadenectomy, and long ischemia due to the Pringle maneuver could be responsible of post-liver resection acute pancreatitis, but the exact...
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doaj-f48d6da005fa41fbb8718be70ab8aeea2021-10-03T11:09:59ZengBMCBMC Surgery1471-24822021-10-012111510.1186/s12893-021-01354-5The white test for intraoperative screening of bile leakage: a potential trigger factor for acute pancreatitis after liver resection—a case seriesSophie Chopinet0Emilie Bollon1Jean-François Hak2Laurent Reydellet3Valéry Blasco4Farouk Tradi5Guillaume Louis6Emilie Grégoire7Jean Hardwigsen8Department of Digestive Surgery and Liver Transplantation, Hôpital la TimoneDepartment of Digestive Surgery and Liver Transplantation, Hôpital la TimoneDepartment of Radiology, Hôpital de la TimoneDepartment of Anesthesiology, Hôpital la TimoneDepartment of Anesthesiology, Hôpital la TimoneDepartment of Radiology, Hôpital de la TimoneDepartment of Radiology, Hôpital de la TimoneDepartment of Digestive Surgery and Liver Transplantation, Hôpital la TimoneDepartment of Digestive Surgery and Liver Transplantation, Hôpital la TimoneAbstract Background Acute pancreatitis after liver resection is a rare but serious complication, and few cases have been described in the literature. Extended lymphadenectomy, and long ischemia due to the Pringle maneuver could be responsible of post-liver resection acute pancreatitis, but the exact causes of AP after hepatectomy remain unclear. Cases presentation We report here three cases of AP after hepatectomy and we strongly hypothesize that this is due to the bile leakage white test. 502 hepatectomy were performed at our center and 3 patients (0.6%) experienced acute pancreatitis after LR and all of these three patients underwent the white test at the end of the liver resection. None underwent additionally lymphadenectomy to the liver resection. All patient had a white-test during the liver surgery. We identified distal implantation of the cystic duct in these three patients as a potential cause for acute pancreatitis. Conclusion The white test is useful for detection of bile leakage after liver resection, but we do not recommend a systematic use after LR, because severe acute pancreatitis can be lethal for the patient, especially in case of distal cystic implantation which may facilitate reflux in the main pancreatic duct.https://doi.org/10.1186/s12893-021-01354-5Acute pancreatitisWhite testHepatectomyBile leakageCase series |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Sophie Chopinet Emilie Bollon Jean-François Hak Laurent Reydellet Valéry Blasco Farouk Tradi Guillaume Louis Emilie Grégoire Jean Hardwigsen |
spellingShingle |
Sophie Chopinet Emilie Bollon Jean-François Hak Laurent Reydellet Valéry Blasco Farouk Tradi Guillaume Louis Emilie Grégoire Jean Hardwigsen The white test for intraoperative screening of bile leakage: a potential trigger factor for acute pancreatitis after liver resection—a case series BMC Surgery Acute pancreatitis White test Hepatectomy Bile leakage Case series |
author_facet |
Sophie Chopinet Emilie Bollon Jean-François Hak Laurent Reydellet Valéry Blasco Farouk Tradi Guillaume Louis Emilie Grégoire Jean Hardwigsen |
author_sort |
Sophie Chopinet |
title |
The white test for intraoperative screening of bile leakage: a potential trigger factor for acute pancreatitis after liver resection—a case series |
title_short |
The white test for intraoperative screening of bile leakage: a potential trigger factor for acute pancreatitis after liver resection—a case series |
title_full |
The white test for intraoperative screening of bile leakage: a potential trigger factor for acute pancreatitis after liver resection—a case series |
title_fullStr |
The white test for intraoperative screening of bile leakage: a potential trigger factor for acute pancreatitis after liver resection—a case series |
title_full_unstemmed |
The white test for intraoperative screening of bile leakage: a potential trigger factor for acute pancreatitis after liver resection—a case series |
title_sort |
white test for intraoperative screening of bile leakage: a potential trigger factor for acute pancreatitis after liver resection—a case series |
publisher |
BMC |
series |
BMC Surgery |
issn |
1471-2482 |
publishDate |
2021-10-01 |
description |
Abstract Background Acute pancreatitis after liver resection is a rare but serious complication, and few cases have been described in the literature. Extended lymphadenectomy, and long ischemia due to the Pringle maneuver could be responsible of post-liver resection acute pancreatitis, but the exact causes of AP after hepatectomy remain unclear. Cases presentation We report here three cases of AP after hepatectomy and we strongly hypothesize that this is due to the bile leakage white test. 502 hepatectomy were performed at our center and 3 patients (0.6%) experienced acute pancreatitis after LR and all of these three patients underwent the white test at the end of the liver resection. None underwent additionally lymphadenectomy to the liver resection. All patient had a white-test during the liver surgery. We identified distal implantation of the cystic duct in these three patients as a potential cause for acute pancreatitis. Conclusion The white test is useful for detection of bile leakage after liver resection, but we do not recommend a systematic use after LR, because severe acute pancreatitis can be lethal for the patient, especially in case of distal cystic implantation which may facilitate reflux in the main pancreatic duct. |
topic |
Acute pancreatitis White test Hepatectomy Bile leakage Case series |
url |
https://doi.org/10.1186/s12893-021-01354-5 |
work_keys_str_mv |
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