Fibrin glue effectiveness and tolerance after elective liver resection: a randomized trial
Noun, R.; Elias, D.; Balladur, P.; Bismuth, H.; Parc, R.; Lasser, P.; Belghiti, J.
Hepato-Gastroenterology 43(7): 221-224
1996
ISSN/ISBN: 0172-6390 PMID: 8682467 Document Number: 455369
Background/Aims: The propensity of fibrin glue to achieve ultimate control of the liver raw surface and its tolerance after hepatic resection, were evaluated by a prospective study. Materials and Methods: Seventy-seven patients undergoing elective liver resection for benign lesions (n = 35) and malignant lesions (n = 42) including 7 with cirrhosis were studied. Randomization took place only at peritoneal closure and after completion of hemostasis and biliostasis. Results: In the group with fibrin glue (n = 38), a single dose of 5ml was applied to the liver cut surface. The appearance of the liver margin at abdominal closure was judged as dry in 34/35 (97%) patients with fibrin glue, versus 34/42 (81%) in those without (p = 0.016). Although postoperative morbidity and mortality were not different between the 2 groups, the mean total fluid drainage during the three postoperative days and bilirubin concentration were significantly lower in the group with fibrin glue; respectively 242 +- 249 ml vs 505+-666 ml and 24 +- 21 mmoles/l vs 65 +- 47 mmoles/l. Conclusions: Our results indicate that fibrin glue application to the hepatic stump after hepatic resection provides effective sealing with good systemic and local compatibility.