Hayashibe Akira, Sakamoto Kazuki, Shinbo Masaya, Makimoto Shinichiro, Nakamoto Takeshi
Department of Surgery, Kishiwada Tokushukai Hospital, Kishiwada City, Osaka, Japan.
J Surg Oncol. 2006 Jul 1;94(1):57-60. doi: 10.1002/jso.20548.
The usefulness of fibrin glue and bioabsorbable polyglicolic acid (PGA) felt to prevent the bile leakage was studied.
Eighty-eight patients who underwent hepatic resection without biliary reconstruction from 2001 through 2005 were studied. We divided 88 patients into 37 patients of Group A (who underwent hepatic resection between January 2001 and March 2003) and 51 patients of Group B (who underwent hepatic resection between April 2003 and January 2005). The fibrin glue was applied to the excision site of remnant liver in the patients of Group A. On the other hand, the fibrin glue and bioabsorbable PGA sheet were applied in the patients of Group B.
In Group A, the post-operative bile leakage occurred in 3 of 37 patients (8.1%). The post-operative bleeding occurred in 1 of 37 patients (2.7%). And the post-operative wound infection occurred in 4 patients (10.8%). In Group B, no post-operative bile leakage and bleeding were observed in 51 patients. And the post-operative wound infection occurred in 3 patients (5.9%). The difference between Groups A and B in the rate of bile leakage was statistically significant.
The combination of fibrin glue and bioabsorbable PGA felt was extremely favorable for prevention of bile leakage after hepatic resection.
研究了纤维蛋白胶和可生物吸收的聚乙醇酸(PGA)毡预防胆漏的有效性。
对2001年至2005年接受肝切除且未行胆道重建的88例患者进行研究。我们将88例患者分为A组37例(2001年1月至2003年3月接受肝切除)和B组51例(2003年4月至2005年1月接受肝切除)。A组患者在残余肝切除部位应用纤维蛋白胶。另一方面,B组患者应用纤维蛋白胶和可生物吸收的PGA片。
A组37例患者中有3例(8.1%)发生术后胆漏。37例患者中有1例(2.7%)发生术后出血。4例患者(10.8%)发生术后伤口感染。B组51例患者未观察到术后胆漏和出血。3例患者(5.9%)发生术后伤口感染。A组和B组胆漏发生率的差异具有统计学意义。
纤维蛋白胶和可生物吸收的PGA毡联合应用对预防肝切除术后胆漏极为有利。