The efficacy of fat emulsion and normal saline for bile leakage tests during hepatic resection: A randomized trial

Objective: A randomized controlled trial to evaluate the use of fat emulsion and normal saline for bile leakage tests during hepatic resection. Methods: Patients were randomized to undergo intraoperative bile leakage tests with saline then fat emulsion (Group A), or fat emulsion then saline (Group B). All patients received both tests. Results: In group A (n ¼ 64), saline revealed 53 leakage points in 27 patients, and fat emulsion revealed 42 additional points in a further nine patients. In group B (n ¼ 64), fat emulsion revealed 87 leakage points in 37 patients, and saline revealed three additional points in three patients. There were no significant between-group differences in the number of leakage points detected by the first test, total number of leakage points or postoperative complications. Significantly more leakage points were detected by the second test in Group A (fat emulsion) than in Group B (saline). Conclusions: Fat emulsion then saline identifies more leakage points after the first test than saline then fat emulsion. There is no difference in the total number of leakage points detected, regardless of which method is used first.