Routine White test for early Detection of Bile Leak in Elective Liver Resection: a study protocol for a randomised controlled trial at a single high-volume hepatobiliary centre in Poland (DELiveR trial)

Introduction: Bile leak (BL) remains one of the most common complications following liver resection, contributing to increased morbidity, prolonged hospitalisation and higher healthcare costs. Early intraoperative detection of open bile ducts is essential for minimising this risk. The intraoperative White test (WT), which involves retrograde injection of a lipid emulsion into the biliary tree, has been shown to enhance visualisation of BL and may reduce their incidence. However, the benefit of routine WT use across all types of liver resections has not been conclusively established. The Detection of Bile Leak in Elective Liver Resection (DELiveR) trial aims to evaluate the effectiveness and safety of routine intraoperative WT in elective liver surgery.