%0 Journal Article
%T A Randomized Clinical Trial Comparing the Effect of Different Haemostatic Agents for Haemostasis of the Liver after Hepatic Resection
%A Farzad Kakaei
%A Mir Salim Seyyed Sadeghi
%A Behnam Sanei
%A Shahryar Hashemzadeh
%A Afshin Habibzadeh
%J HPB Surgery
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/587608
%X Introduction. Operative blood loss is still a great obstacle to liver resection, and various topical hemostatic agents were introduced to reduce it. The aim of the current study is to evaluate effects of 3 different types of these agents. Methods. In this randomized clinical trial, 45 patients undergoing liver resection were assigned to receive TachoSil, Surgicel, and Glubran 2 for controlling bleeding. Intraoperative and postoperative findings were compared between groups. Results. Postoperative bleeding (0 versus 33.3%, ) and drainage volume first day after surgery ( versus £¿mL, ) were significantly higher in Surgicel than in TachoSil group. Postoperative complications included bile leak (3 cases in Surgicel, 1 case in TachoSil and Glubran 2), noninfectious collection (2 cases in TachoSil and Surgicel and 1 case in Glubran 2), perihepatic abscess, and massive hematoma around hepatectomy site both in Surgicel group. There was no death during the study period. Conclusion. Due to higher complications in Surgicel group, its application as hemostatic agent after liver resection is not recommended. Better results in TachoSil in comparison to the other two are indicative of its better efficacy and superiority in controlling hemostasis. 1. Introduction Advances in surgical technique have reduced the occurrence of postoperative complications following liver resection [1] and resulted in low surgical mortality and morbidity rates in high-volume centers [2¨C4]. Surgical techniques and devices to facilitate haemostasis have been developed in the last decades and have minimized operative risks of liver resection [1, 2]. During liver resection, the control of bleeding is a major concern. Despite the improvements in anatomic resection and dissection techniques, operative blood loss remains a major problem affecting the prognosis of patients undergoing liver resection [2, 5]. Nevertheless, a parenchymal transection of the liver tissue is always associated with some degree of bleeding due to the division of small blood vessels which cannot be isolated and ligated [6, 7]. In order to control diffuse bleeding and to prevent intraperitoneal complications attributed to bleeding, various topical products are used when the conventional methods, such as suture, ligation, or argon beam coagulation, fail. Currently, there are numerous products on the market which are promising a successful outcome for hemostasis. These products include gelatin, collagen, oxidized regenerated cellulose, fibrin sealant glues, and synthetic glues [7¨C11]. TachoSil (fibrin sealant glue) and Surgicel
%U http://www.hindawi.com/journals/hpb/2013/587608/