A Prospective Study of the Efficacy of Clinical Application of a New Carrier-Bound Fibrin Sealant After Liver Resection

Objective: To examine the effectiveness of fibrin sealants as supportive treatment to improve hemostasis and decrease the incidence of bile leakage and intra-abdominal collections. Design: Prospective, controlled, quasiexperimental study. Setting: Tertiary referral center, University Hospital Reina Sofia. Patients: A total of 115 patients (58 in the control group and 57 in the collagen sponge group) scheduled for conventional hepatectomies. Interventions: Patients were distributed into groups for major and minor hepatectomies with or without application of a carrier-bound collagen sponge on the raw surface of the liver. Main Outcome Measures: The main outcome measures were postoperative mortality, incidence and severity of postoperative surgical complications, and length of hospital stay. The secondary outcome measures were post-operative drainage output volume, transfusion requirements, and changes in biochemical parameters (hemoglobin, bilirubin, alanine aminotransferase, and platelet levels). Results: The fibrin sealant after major liver resection was effective for decreasing drainage volume (mean [SD] volume, 1124.7 [842.8] mL in the control group and 691.2 [499.5] mL in the collagen sponge group; P=.007) with a higher volume of output by drain each postoperative day in the control patients (P=.003); postoperative blood transfusion requirements (18.9% vs 7.0%, respectively; P=.04); moderate to severe postoperative complications (21% vs 8%, respectively; P=.03); and mean (SD) hospital stay (12.6[6.7] vs 9.6[5.1] days, respectively; P=.03). Conclusion: The use of a new carrier-bound collagen sponge after major liver resection may be recommended because of its clinical and cost-savings effectiveness.