Clinical Analysis Of Intraoperative Methylene Blue Test In Preventing The Incidence Of Bile Leakage After Hepatectomy

Objective:The research explore the value of methylene blue test in reducing the incidence of bile leakage and other complications after hepatectomy.Methods:68 patients with hepatectomy admitted to our hospital from September 2018 to December 2019 were selected as the research objects.They were randomly divided into methylene blue group(n=36)and conventional group(n=32).In the methylene blue group,hemostasis was strictly performed on the wound,the lower part of the common bile duct was blocked,and methylene blue was injected into the bile duct system to detect the bile leakage.If the bile leakage was found,it was repaired,then the abdominal drainage tube was retained.In the conventional group,the bile leakage was detected by covering the wound with white gauze.There were no significant difference between the two groups(P>0.05)in age,gender,comorbidity including hypertension,diabetes and cirrhosis,nature of disease,pathological location,child's grade,liver function including serum total bilirubin(TBIL),alanine aminotransferase(ALT)and albumin,disease type and operation mode.Intraoperative observation indexes include operation time,surgical bleeding volume,bile leakage detected during the operation and intraoperative bile leakage point.Postoperative observation indexes include the liver function of three days after operation,abdominal drainage and fluid bilirubin measurement,complications including bile leakage,abdominal effusion,abdominal infection,pleural effusion,pulmonary infection and incision infection,drainage tube extubation time,hospitalization days and expenses.Spss21.0 software was used to analyze the relevant data.If P<0.05,the difference was statistically significant,but if P>0.05,the difference was not statistically significant.Results:68 patients were successfully operated without death.The methylene blue group successfully performed the methylene blue bile leakage test with no related complications.The bile leakage detected during the operation(52.8%vs 21.9%)and the intraoperative bile leakage point in the methylene blue group were higher than the conventional group(P<0.05).In the methylene blue group,the incidence rate of postoperative complication such as bile leakage,abdominal effusion,abdominal drainage flow and fluid bilirubin measurement,drainage tube extubation time,hospitalization days and expenses were significantly lower than those of the conventional group(P<0.05).However,there were no significantly differences between two groups in operation time,surgical bleeding volume,the liver function of three days after operation,the incidence rate of postoperative complication such as abdominal infection,pleural effusion,pulmonary infection and incision infection(P>0.05).Conclusions:The methylene blue bile leakage test in hepatectomy has high feasibility and safety.It can accurately locate the point of bile leakage in time during operation,effectively reduce the incidence of postoperative bile leakage and related complications,which has preferable clinical value and is worth popularizing.