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


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 5 ml 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.
Noun
R
R
Department of Digestive Surgery, Hospital Beaujont, France.
Elias
D
D
Balladur
P
P
Bismuth
H
H
Parc
R
R
Lasser
P
P
Belghiti
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004322:Drainage; D004361:Drug Tolerance; D017558:Elective Surgical Procedures; D005069:Evaluation Studies as Topic; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000494:pharmacology / Q000627:therapeutic use*; D006490:Hemostatics / Q000494:pharmacology / Q000627:therapeutic use*; D006498:Hepatectomy; D006801:Humans; D008099:Liver / Q000187:drug effects*; D008107:Liver Diseases / Q000601:surgery; D008113:Liver Neoplasms / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
D015718:Fibrin Tissue Adhesive; D006490:Hemostatics