Berrevoet F, de Hemptinne B
Department of General Surgery, Hepatobiliary and Liver Transplantation Service, Ghent University Hospital Medical School, Belgium.
Acta Chir Belg. 2007 Sep-Oct;107(5):504-7. doi: 10.1080/00015458.2007.11680111.
Hepatic resections are considered as a standard intervention in abdominal surgery. However there is still a remarkable complication rate. Despite all recent developments in surgical techniques during liver surgery, blood loss is still one of the main causes for postoperative morbidity and mortality. In addition to patient-dependent factors, aspects of the surgical technique play a major role, in particular with regard to the occurrence of peri-operative bleeding, fluid accumulation and bile leakage. Nowadays, the use of topical sealants is often recommended as an additional tool to decrease postoperative bleeding and bile fistula. Fibrin sealants are able not only to enhance clot formation and wound healing, but possibly work as a sealing device for the small biliary branches. In this overview we will try to evaluate the efficacy in terms of time to complete haemostasis, the need for blood transfusions and the incidence of bile leakage according to recent trials. Furthermore the clinical benefit for the liver surgery patient will be discussed.
肝切除术被视为腹部手术的标准干预措施。然而，其并发症发生率仍然很高。尽管肝脏手术的外科技术最近有了所有进展，但失血仍然是术后发病和死亡的主要原因之一。除了患者相关因素外，手术技术方面起着主要作用，特别是在围手术期出血、液体蓄积和胆漏的发生方面。如今，经常推荐使用局部密封剂作为减少术后出血和胆瘘的附加工具。纤维蛋白密封剂不仅能够增强凝血形成和伤口愈合，而且可能作为小胆管分支的密封装置。在本综述中，我们将根据最近的试验，尝试评估在完成止血时间、输血需求和胆漏发生率方面的疗效。此外，还将讨论对肝脏手术患者的临床益处。
