Patrone Renato, Granata Vincenza, Belli Andrea, Palaia Raffaele, Albino Vittorio, Piccirillo Mauro, Fusco Roberta, Tatangelo Fabiana, Nasti Guglielmo, Avallone Antonio, Izzo Francesco
PhD ICTH, University Federico II, Via Sergio Pansinin 5, 80131, Naples, Italy.
Department of Support to Cancer Pathways Diagnostics Area, Radiology Unit, "Istituto Nazionale Tumori IRCCS Fondazione Pascale - IRCCS di Napoli", Naples, Italy.
Infect Agent Cancer. 2021 Mar 16;16(1):19. doi: 10.1186/s13027-021-00358-3.
Biloma, an encapsulated collection of bile outside the biliary tree, supported by a predominantly iatrogenic biliary fistula, and bile likeage are two of the most important surgical complications after liver resection. We, hypothesized to conduct a project aimed to prevent, or reduce, the formation of biloma or biliary fistula applying on the hepatic resection area the cyanoacrylate glue (Glubran2).
We searched in our surgical database all patients underwent liver resection for mCRC from January 2013 to December 2018 and we found a total of 510 patients. 205 patients for Group A (study population: included patients in which we have used Glubran2 during surgical procedure) and 113 patients for Group B (control group), were enrolled.
In both Groups no patients died during hospitalization and the 30-day mortality was 0 %. During follow-up in Group A, a biliary fistula was found in 2 patients (1 %) versus 3 patients in the Group B (2,6 %). In patients enrolled in Group A no adverse event were reported relate to the use of Glubran2.
It is possible to affirm that the use of Glubran2 as biliostatic agent after liver resection is useful to prevent bile leakage complication and biloma formation and its use demonstrated to be safe and feasible during liver surgery.
胆汁瘤是指在胆管树外包裹性胆汁聚集,主要由医源性胆瘘引起,胆汁渗漏是肝切除术后两种最重要的手术并发症。我们假设开展一个项目,旨在通过在肝切除区域应用氰基丙烯酸酯胶水(Glubran2)来预防或减少胆汁瘤或胆瘘的形成。
我们在手术数据库中搜索了2013年1月至2018年12月期间因转移性结直肠癌接受肝切除的所有患者,共找到510例患者。纳入了A组205例患者(研究人群:包括手术过程中使用了Glubran2的患者)和B组113例患者(对照组)。
两组患者住院期间均无死亡,30天死亡率为0%。随访期间,A组有2例患者(1%)出现胆瘘,而B组有3例患者(2.6%)出现胆瘘。A组纳入的患者中未报告与使用Glubran2相关的不良事件。
可以肯定的是,肝切除术后使用Glubran2作为胆汁抑制药物有助于预防胆汁渗漏并发症和胆汁瘤形成,并且其在肝脏手术中的使用被证明是安全可行的。