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

Erdogan, Deha; Busch, Olivier R.; Gouma, Dirk J.; Gulik, Thomas M. van

doi:10.1159/000103661

Cited by 35 publications

(32 citation statements)

References 43 publications

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“…Most studies from North America, Europe, and East Asia reported rates of moderate and severe dementia ranging between 3 and 7% for populations over 65 years of age [14]. However, worldwide, the prevalence rates of dementia in different studies vary from very low (0.62%) in Kolkata, India, for a population aged 50 years and more [15], to very high in Israel (19.2%) in a population aged 65 years and more [16]. Whatever the true prevalence turns out to be, it is clear that rates of dementia increase steeply and dramatically with age.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Dementia in Al Kharga District, New Valley Governorate, Egypt

et al. 2012

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Background: With aging, there is a parallel increase in the prevalence of dementia worldwide. The aim of this work is to determine the prevalence of dementia among the population of Al Kharga District, New Valley, Egypt. Methods: Screening of all subjects aged ≥50 years (n = 8,173 out of 62,583 inhabitants) was done through a door-to-door survey by 3 neurologists, using a short standardized Arabic screening test and a modified Mini-Mental State Examination. Suspected cases were subjected to full clinical examination, psychometric assessment using the Cognitive Abilities Screening Instrument, Instrumental Activities of Daily Living Scale, Geriatric Depression Scale, Hachinski Ischemic Score, DSM-IV-TR diagnostic criteria, neuroimaging, and laboratory investigations, when indicated. Results: The prevalence rate of dementia was 2.26% for the population aged ≥50 years. It increased steeply with age to a maximum of 18.48% for those aged ≥80 years. Alzheimer’s disease (51.2%) was the most common subtype, followed by vascular dementia (28.7%), dementia due to general medical conditions (12.8%), and lastly dementia due to multiple etiologies (7.3%). Mild dementia was the commonest (53.7%). Conclusion: Dementia is prevalent in Egypt as elsewhere. Detection through a door-to-door surveyis the best method in developing countriesfor early detection of mild cases.

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Section: Discussionmentioning

confidence: 99%

Prevalence of Dementia in Al Kharga District, New Valley Governorate, Egypt

et al. 2012

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“…Risk factors for bile leakage are high-risk procedures with exposure of the major glissonian sheath [3,4,26,28], resections combined with bilioenteric anastomosis [29,30], size of resection plane [26], patient age [28], higher preoperative white blood cell count [28], and prolonged operation time [3,28]. In a retrospective series of more than 600 patients, Capussotti et al [4] showed an association between the application of fibrin sealant on the resection surface and a lower incidence of bile leakage (RR = 0.38, p = 0.046).…”

Section: Fibrin Sealants and Prevention Of Bile Leakagementioning

confidence: 99%

Role of Fibrin Sealants in Liver Surgery

et al. 2012

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Background: Fibrin sealants are widely used in liver surgery. The aim of this article is to review the literature on evidence of hemostatic and biliostatic capacities of different fibrin sealants in liver surgery. Methods: In PubMed, a literature search was done with the search terms ‘fibrin sealant’ or ‘fibrin glue’ combined with ‘liver resection’ or ‘bile leakage’. Thirteen comparative fibrin sealant studies were selected. Results: In general, these studies have shown a reduced time to hemostasis when fibrin sealants were used. So far, only a few studies have been published that have focused on postoperative resection surface-related complications. There is no strong evidence that fibrin sealants reduce the incidence of bile leakage after liver resection. Important new evidence shows that bile contains profibrinolytic activity that causes lysis of the clot formed by the fibrin sealant at least in vitro. Conclusions: Fibrin sealants can be effective as an adjunct to achieve hemostasis during liver resections. However, considering lack of evidence on the efficacy of fibrin sealants in reducing postoperative resection surface-related complications, routine use of fibrin sealants in liver surgery cannot be recommended.

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“…Biliary leakage may lead to intraperitoneal septic complications, liver failure and ultimately, death [3]. The incidence and management of bile leakage after partial liver resection in our Department from 1992 to 2004 has been reported by Erdogan et al [4,5]. However, the management of this complication has changed from relaparotomies to mainly non-surgical interventions in the last years, potentially leading to a decrease in procedure-related complications and better outcomes.…”

Section: Introductionmentioning

confidence: 99%

Posthepatectomy Bile Leakage: How to Manage

et al. 2012

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Background: Biliary leakage after liver resection continues to be reported. Management of bile leakage has changed in recent years, with nowadays non-surgical procedures as the preferred treatment. Methods: Biliary leakage and management were assessed in 381 patients who underwent liver resection between January 2005 and April 2011. Results: The overall rate of biliary leakage after liver resection was 5.0%, with a higher incidence in patients who had undergone concomitant hepaticojejunostomy (HJ; 13.6 vs. 3.2%). Hospital stay (p = 0.047), major resections (p = 0.018), operation time (p = 0.011), and relaparotomy (p = 0.002) were risk factors for postoperative bile leakage. Multivariate analysis identified relaparotomy as an independent factor (OR 4.216, p = 0.034). Bile leakage in patients without HJ (n = 10) was managed in 6 patients by percutaneous transhepatic biliary drainage (PTD), and in 3 patients by endoscopic drainage. One patient was treated surgically. All patients with an HJ and postoperative bile leakage (n = 9) underwent PTD. Conclusion: The incidence of posthepatectomy biliary leakage has decreased over time, while PTD and endoscopic stenting are effective treatment modalities. PTD is the treatment of choice in bile leakage after resection combined with HJ.

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

Cited by 35 publications

References 43 publications

Prevalence of Dementia in Al Kharga District, New Valley Governorate, Egypt

Prevalence of Dementia in Al Kharga District, New Valley Governorate, Egypt

Role of Fibrin Sealants in Liver Surgery

Posthepatectomy Bile Leakage: How to Manage

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