New method for prevention of bile leakage after hepatic resection

BACKGROUND: The usefulness of fibrin glue and bioabsorbable polyglicolic acid (PGA) felt to prevent the bile leakage was studied. METHODS: 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. RESULTS: 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. CONCLUSIONS: The combination of fibrin glue and bioabsorbable PGA felt was extremely favorable for prevention of bile leakage after hepatic resection.