Analysis of the biliostatic potential of two sealants in a standardized porcine model of liver resection

作者：Fonouni H^*; Kashfi A; Stahlheber O; Konstantinidis L; Kraus T W; Mehrabi A; Oweira H

来源：American Journal of Surgery, 2017, 214(5): 945-955.

DOI：10.1016/j.amjsurg.2017.06.038

• Biliostasis
• Sealant
• Fibrin glue
• Liver resection

Background: Improved resection techniques has decreased mortality rate following liver resections(LRx). Sealants are known as effective adjuncts for haemostasis after LRx. We compared biliostatic effectiveness of two sealants in a standardized porcine model of LRx.
Material and methods: We accomplished left hemihepatectomy on 27 pigs. The animals were randomized in control group(n = 9) with no sealant and treatment groups (each n = 9), in which resection surfaces were covered with TachoSil (R) and TissuFleece (R)/Tissucol Duo (R). After 5 days the volume of ascites(ml), bilioma and/or bile leakages and degree of intra-abdominal adhesions were analysed.
Results: Proportion of ascites was lower in TissuFleece/Tissucol Duo (R) group. The ascites volume was lower in TachoSil (R) group. In sealant groups, increased adhesion specially in the TachoSil (R) group was seen. A reduction of the "bilioma rate" was seen in sealant groups, which was significantly lower in TissuFleece (R)/Tissucol Duo (R) group.
Conclusion: In a standardized condition sealants have a good biliostatic effect but with heterogeneous potentials. This property in combination with the cost-benefit analysis should be the focus of future prospective studies.

• 出版日期2017-11