title: Concentrated albumin as a biological glue for hemorrhage control on hepatic resection with argon beam coagulation.
abstract: Topically applied concentrated albumin with argon beam coagulation (ABCA) has been shown to be more effective at achieving hemostasis than using argon beam coagulation alone (ABC) in a liver injury model. This study investigated the host response to the concentrated albumin after argon beam coagulation. Complete hemostasis was achieved using ABCA (N = 10) or ABC (N = 10) on a nonanatomic liver resection in a heparinized porcine model. The repairs were evaluated grossly and microscopically at postoperative periods of 30 and 90 days. We found no evidence of biliary leakage, rebleeding, or intraabdominal infection. Blood analysis indicated liver chemistry indices were within normal range after ABC and ABCA treatments. The histopathology showed that the postoperative healing response was similar in both groups: a moderate chronic inflammatory response as part of an on-going normal healing process. All repairs were encapsulated by fibrous tissue. There was no difference in the postsurgical adhesion scores for the ABCA (mean 3.4) and ABC (mean 3.8). It was concluded that use of the concentrated albumin as biological glue in conjunction with argon beam coagulation is a safe and efficient procedure for controlling hepatic hemorrhage in surgery. Further studies are warranted to investigate the clinical significance of this technique.
authors.affiliation: Oregon Medical Laser Center, Providence St. Vincent Medical Center, 9205 SW Barnes Raod, Portland, Oregon 97225, USA. hxie@providence.org
authors.forename: Hua
authors.initials: H
authors.lastname: Xie
authors.forename: Ronald F
authors.initials: RF
authors.lastname: Wolf
authors.forename: Allen P
authors.initials: AP
authors.lastname: Burke
authors.forename: Scott B
authors.initials: SB
authors.lastname: Gustafson
authors.forename: Kenton W
authors.initials: KW
authors.lastname: Gregory
authors.forename: Scott A
authors.initials: SA
authors.lastname: Prahl
mesh_terms: D000269:Adhesives / Q000627:therapeutic use*; D000410:Alanine Transaminase / Q000097:blood; D000469:Alkaline Phosphatase / Q000097:blood; D000818:Animals; D001219:Aspartate Aminotransferases / Q000097:blood; D001777:Blood Coagulation / Q000187:drug effects; D006470:Hemorrhage / Q000628:therapy*; D006487:Hemostasis; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008111:Liver Function Tests; D008422:Materials Testing; D023421:Models, Animal; D012709:Serum Albumin; D013552:Swine
chemical_list: D000269:Adhesives; D012709:Serum Albumin; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D000469:Alkaline Phosphatase