Clinical Application of Topical Sealants in Liver Surgery: Does it Work ?

Abstract

Hepatic resections are considered as a standard intervention in abdominal surgery. However there is still a remarkable complication rate. Despite all recent developments in surgical techniques during liver surgery, blood loss is still one of the main causes for postoperative morbidity and mortality. In addition to patient-dependent factors, aspects of the surgical technique play a major role, in particular with regard to the occurrence of peri-operative bleeding, fluid accumulation and bile leakage. Nowadays, the use of topical sealants is often recommended as an additional tool to decrease postoperative bleeding and bile fistula. Fibrin sealants are able not only to enhance clot formation and wound healing, but possibly work as a sealing device for the small biliary branches. In this overview we will try to evaluate the efficacy in terms of time to complete haemostasis, the need for blood transfusions and the incidence of bile leakage according to recent trials. Furthermore the clinical benefit for the liver surgery patient will be discussed.

Key Words:

• Fibrin glue
• topical sealing agents
• liver surgery
• bile leakage

Additional information

Notes on contributors

F. Berrevoet

F. Berrevoet Department of Surgery, Hepatobiliary and Liver Transplantation Service Ghent University Hospital Medical School 2K12 IC De Pintelaan 185 B-9000 Gent, Belgium Tel.: [phone] Fax: [phone] E-mail: [email protected]