Fibrin glue effectiveness and tolerance after elective liver resection: a randomized trial

Area of Science:

• Hepatobiliary Surgery
• Surgical Hemostasis
• Biomaterials in Medicine

Background:

• Hepatic resection involves managing raw liver surfaces to prevent bleeding and bile leaks.
• Fibrin glue is a hemostatic agent with potential applications in liver surgery.
• Evaluating the efficacy and safety of fibrin glue for liver surface sealing is crucial.

Purpose of the Study:

• To assess the effectiveness of fibrin glue in achieving hemostasis and biliostasis on the liver raw surface after hepatic resection.
• To evaluate the local and systemic tolerance of fibrin glue in patients undergoing liver surgery.
• To compare postoperative outcomes in patients treated with and without fibrin glue.

Main Methods:

• A prospective study involving 77 patients undergoing elective liver resection for benign or malignant lesions.
• Fibrin glue (5 ml single dose) was applied to the liver cut surface in the treatment group (n=38).
• Randomization occurred at peritoneal closure; hemostasis and biliostasis were assessed at abdominal closure.

Main Results:

• Fibrin glue resulted in a significantly higher rate of dry liver margins at closure (97% vs 81%, p=0.016).
• Patients receiving fibrin glue had significantly lower mean total postoperative fluid drainage (242 ml vs 505 ml).
• Mean postoperative bilirubin concentrations were significantly lower in the fibrin glue group (24 mmol/l vs 65 mmol/l).

Conclusions:

• Fibrin glue application to the hepatic stump after resection provides effective sealing of the liver raw surface.
• The use of fibrin glue demonstrates good systemic and local compatibility.
• Fibrin glue is a valuable adjunct for improving outcomes in hepatic resection.