New method for prevention of bile leakage after hepatic resection

Hayashibe, Akira; Sakamoto, Kazuki; Shinbo, Masaya; Makimoto, Shinichiro; Nakamoto, Takeshi

doi:10.1002/jso.20548

Cited by 82 publications

(57 citation statements)

References 22 publications

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“…Hayashibe at al. [30] analyzed 88 patients after liver resection without biliary reconstruction. The first group of 37 patients with fibrin glue on the resection surface showed biliary leakage in 8.1%, and the second group of 51 patients in whom fibrin glue was combined with bioabsorbable polyglycolic acid sheet showed no postoperative biliary leakage at all (p = 0.003).…”

Section: Biliostatic Efficacy Of Topical Hemostatic Agentsmentioning

confidence: 99%

Prevention of Biliary Leakage after Partial Liver Resection Using Topical Hemostatic Agents

et al. 2007

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Liver resection is widely accepted as the only potentially curative treatment in malignant or benign hepatobiliary lesions. Although not frequent, biliary leakage is a postoperative complication which may have considerable consequences. The field of topical hemostatic agents is rapidly developing, with various products currently available. This article reviews the risk factors associated with biliary leakage and the methods used for testing or prevention of biliary leakage. A literature search was performed using key words related to experimental and clinical studies dealing with biliary leakage. Experimental studies assessed the potential biliostatic effect of different topical hemostatic agents after bile duct reconstruction. Clinical series show biliary leakage rates up to 12%. There is no evidence that flushing of the bile duct system after resection reduces the incidence of biliary leakage. Further controlled studies are needed to clarify the preventive effect of topical hemostatic agents on biliary leakage after liver resection.

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Section: Biliostatic Efficacy Of Topical Hemostatic Agentsmentioning

confidence: 99%

Prevention of Biliary Leakage after Partial Liver Resection Using Topical Hemostatic Agents

et al. 2007

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“…The author concluded that the used sealant was effective in decreasing the incidence of bile leakage from 56% in the control group to 11% in the sealant group. Hayashibe et al [36] published the results of a retrospective analysis of 88 patients in which they compared the use of fibrin glue in combination with bioabsorbable polyglycol acid (PGA) felt versus fibrin glue alone. They conclude again that sealing with fibrin glue and PGA felt is extremely favorable in the prevention of bile leakage.…”

Section: Clinical Applicationsmentioning

confidence: 99%

Use of Topical Hemostatic Agents during Liver Resection

Berrevoet

Hemptinne²

2007

Dig Surg

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Despite all recent developments in surgical techniques during liver surgery, blood loss is still one of the main causes for postoperative morbidity and mortality. Other complications include bile leakage and fluid accumulation intraperitoneally. Fibrin sealants are able not only to enhance clot formation and wound healing but possibly work as a sealing device for postoperative leakage and fistula formation. In this overview the underlying mechanisms for these agents are discussed and several clinical data concerning liver surgery will be reported.

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“…7 The timely detection and repair of intraoperative bile leakage is extremely important, but small leakage points are often difficult to detect. 7 There are several methods for detecting and/or preventing bile leakage after hepatectomy, including bile leakage tests, 1,8,[12][13][14][15] which detect open bile duct stumps on the resection surface by increasing fluid pressure within the duct. 1,8,12 The fluid used can be saline, which is low cost, nontoxic, has low viscosity (allowing the detection of small leakage points) and can be repeated as many times as needed.…”

Section: Introductionmentioning

confidence: 99%

“…1,8,12 The fluid used can be saline, which is low cost, nontoxic, has low viscosity (allowing the detection of small leakage points) and can be repeated as many times as needed. Saline is difficult to detect, however, because it is colourless, [13][14][15] and its use may not lower the incidence of postoperative bile leakage. 13 This can be overcome by the use of a fluorescent dye, but this requires special equipment and there is a risk of allergic reaction.…”

Section: Introductionmentioning

confidence: 99%

“…Saline is difficult to detect, however, because it is colourless, [13][14][15] and its use may not lower the incidence of postoperative bile leakage. 13 This can be overcome by the use of a fluorescent dye, but this requires special equipment and there is a risk of allergic reaction. 15,16 An alternative is methylene blue, but the dye stains the entire resection surface (preventing the repetition of the procedure), and there is also a risk of allergic reaction.…”

Section: Introductionmentioning

confidence: 99%

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The efficacy of fat emulsion and normal saline for bile leakage tests during hepatic resection: A randomized trial

Liu¹,

Liu²,

Hu³

et al. 2015

J Int Med Res

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Objective: A randomized controlled trial to evaluate the use of fat emulsion and normal saline for bile leakage tests during hepatic resection. Methods: Patients were randomized to undergo intraoperative bile leakage tests with saline then fat emulsion (Group A), or fat emulsion then saline (Group B). All patients received both tests. Results: In group A (n ¼ 64), saline revealed 53 leakage points in 27 patients, and fat emulsion revealed 42 additional points in a further nine patients. In group B (n ¼ 64), fat emulsion revealed 87 leakage points in 37 patients, and saline revealed three additional points in three patients. There were no significant between-group differences in the number of leakage points detected by the first test, total number of leakage points or postoperative complications. Significantly more leakage points were detected by the second test in Group A (fat emulsion) than in Group B (saline). Conclusions: Fat emulsion then saline identifies more leakage points after the first test than saline then fat emulsion. There is no difference in the total number of leakage points detected, regardless of which method is used first.

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New method for prevention of bile leakage after hepatic resection

Abstract: The combination of fibrin glue and bioabsorbable PGA felt was extremely favorable for prevention of bile leakage after hepatic resection.

Cited by 82 publications

References 22 publications

Prevention of Biliary Leakage after Partial Liver Resection Using Topical Hemostatic Agents

Prevention of Biliary Leakage after Partial Liver Resection Using Topical Hemostatic Agents

Use of Topical Hemostatic Agents during Liver Resection

The efficacy of fat emulsion and normal saline for bile leakage tests during hepatic resection: A randomized trial

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