Experimental Study of Fibrin Glue for Preventing and Curing Postoperative Bleeding and Bile Leakage in House-HoldRabbit Following Partial Hepatectomy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WA N G Dong , P EN G J irun , Z HU J iye , L EN G X isheng

Department of Hepatobi l iary S urgery , Peking Uni versi t y , People’s Hos pi tal , Bei j ing 100044 , China;

Corresponding author：

Keywords：

Fibrin glue，Hepatectomy

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【 Abstract 】 Objective To investigate the precautionary effect of fibrin glue on postoperative bleeding and bile leakage when used in partial hepatic resection. Methods House-hold rabbit partial hepatectomy model was prepared and 40 rabbits were divided into sham operation （ SO) group (n=10), control group (n=10) and protocol group (n=20) randomly. The SO rabbits received laparotomy only, while both the control and protocol group received partial hepatectomy. Fibrin glue was used in the protocol group following electric coagulation therapy while the control group received electric coagulation therapy only. The animals’ diet, weight and adverse effects were observed then, and the celiac drainage volume, levels of hemoglobin (Hg), WBC and TBil in celiac outflow and ALT, AST, LDH and TBil in rabbit serum were checked on schedule after operation. Results The average blood loss volume and operation time in the protocol group were (16.0±2.7) ml and (23.7±2.9) min respectively, which were lower than those in the control group 〔 (20.8 ± 3.5) ml and (27.3 ± 2.9) min (P ＜ 0.01) 〕 . The celiac drainage volume, levels of Hg, WBC and TBil in celiac outflow decreased gradually on postoperative days in protocol groups (P ＜ 0.05). The levels of Hg in celiac outflow of the protocol group on the 1st, 2nd and 7th postoperative day were lower than those of the control group (P ＜ 0.05), and the result of TBil was the same on the 1st, 2nd, 3rd, 5th and 7th postoperative day (P ＜ 0.05). The serum ALT, AST, LDH and TBil levels in the control and protocol groups were higher than those in the SO group significantly (P ＜ 0.01), while the serum ALT, AST (except on the 3rd postoperative day) and LDH levels in the protocol group were lower than those in the control group (P ＜ 0.05) in significance.All animals had good appetite, normal weight gain and no adverse reaction 　 and death occurred. Conclusion Application of fibrin glue may effectively prevent and cure the postoperative bleeding and bile leakage in partial hepatectomy without any adverse reaction.

Citation： WA N G Dong,P EN G J irun,Z HU J iye,L EN G X isheng. Experimental Study of Fibrin Glue for Preventing and Curing Postoperative Bleeding and Bile Leakage in House-HoldRabbit Following Partial Hepatectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2008, 15(4): 262-265. doi: Copy

1.	19 　 de Virgilio C, Elbassir M, Hidalgo A, et al. Fibrin glue reduces the severity of intra-abdominal adhesions in a rat model [ J ] . Am J Surg, 1999; 178(6) ∶ 577.
2.	王海东, 郑进方, 邢贻雷, 等. 纤维蛋白胶在普外科手术的应用——附153例临床分析 [J]. 中国微创外科杂志, 2001; 6(3)∶133.
3.	Cothren CC, McIntyre RC Jr, Johnson S, et al. Management of low-output pancreatic fistulas with fibrin glue [J]. Am J Surg, 2004; 188(1)∶89.
4.	Schenk WG 3rd, Burks SG, Gagne PJ, et al. Fibrin sealant improves hemostasis in peripheral vascular surgery: a randomized prospective trial [J]. Ann Surg, 2003; 237(6)∶871.
5.	尚培中, 李德炳, 刘景章, 等. 改良套叠式胰空肠吻合术应用石蕊试纸和纤维蛋白胶预防胰漏47例体会 [J]. 中国普外基础与临床杂志, 2006; 13(2)∶219.
6.	许邦文, 周宁新, 霍宗红. 吸收性止血绫在择期肝部分切除术中的应用 [J]. 中国普外基础与临床杂志, 2002; 9(4)∶276.
7.	Kraus TW, Mehrabi A, Schemmer P, et al. Scientific evidence for application of topical hemostats, tissue glues, and sealants in hepatobiliary surgery [J]. J Am Coll Surg, 2005; 200(3)∶418.
8.	Ederle A, Scattolini C, Bulighin G, et al. Does the combination of a human fibrin sealant with ranitidine accelerate the healing of duodenal ulcer? [J]. Ital J Gastroenterol, 1991; 23(6)∶354.
9.	Canonico S, Sciaudone G, Pacifico F, et al. Inguinal hernia repair in patients with coagulation problems: prevention of postoperative bleeding with human fibrin glue [J]. Surgery, 1999; 125(3)∶315.
10.	Davidson BR, Burnett S, Javed MS, et al. Experimental study of a novel fibrin sealant for achieving haemostasis following partial hepatectomy [J]. Br J Surg, 2000; 87(6)∶790.
11.	詹利永, 王敏, 陆伯豪, 等. 医用胶减少胃癌术后腹腔渗出的随机对照研究 [J]. 中华胃肠外科杂志, 2005; 8（1）∶43.
12.	张献义, 刘宁青, 吕鹏飞, 等. 医用生物蛋白胶在甲状腺手术中的应用 [J]. 中华普通外科杂志, 2004; 19(8)∶511.
13.	杨子彬. 生物止血材料——纤维蛋白胶临床应用进展 [J]. 世界医疗器械, 2001; 7(2)∶24.
14.	Schwartz M, Madariaga J, Hirose R, et al. Comparison of a new fibrin sealant with standard topical hemostatic agents [J]. Arch Surg, 2004; 139(11)∶1148.
15.	Capussotti L, Ferrero A, Viganò L, et al. Bile leakage and liver resection: Where is the risk? [J]. Arch Surg, 2006; 141(7)∶690.
16.	Eder F, Meyer F, Nestler G, et al. Sealing of the hepatic resection area using fibrin glue reduces significant amount of postoperative drain fluid [J]. World J Gastroenterol, 2005; 11(38)∶5984.
17.	Hayashibe A, Sakamoto K, Shinbo M, et al. New method for prevention of bile leakage after hepatic resection [J]. J Surg Oncol, 2006; 94(1)∶57.
18.	Figueras J, Llado L, Miro M, et al. Application of fibrin glue sealant after hepatectomy does not seem justified: results of a randomized study in 300 patients [J]. Ann Surg, 2007; 245(4)∶536.
19.	苏怡, 候延文, 高珉之. 纤维蛋白胶生物性能的研究 [J]. 预防医学情报杂志, 2001; 17(6)∶433.

1. 19 　 de Virgilio C, Elbassir M, Hidalgo A, et al. Fibrin glue reduces the severity of intra-abdominal adhesions in a rat model [ J ] . Am J Surg, 1999; 178(6) ∶ 577.
2. 　王海东, 郑进方, 邢贻雷, 等. 纤维蛋白胶在普外科手术的应用——附153例临床分析 [J]. 中国微创外科杂志, 2001; 6(3)∶133.
3. 　Cothren CC, McIntyre RC Jr, Johnson S, et al. Management of low-output pancreatic fistulas with fibrin glue [J]. Am J Surg, 2004; 188(1)∶89.
4. 　Schenk WG 3rd, Burks SG, Gagne PJ, et al. Fibrin sealant improves hemostasis in peripheral vascular surgery: a randomized prospective trial [J]. Ann Surg, 2003; 237(6)∶871.
5. 　尚培中, 李德炳, 刘景章, 等. 改良套叠式胰空肠吻合术应用石蕊试纸和纤维蛋白胶预防胰漏47例体会 [J]. 中国普外基础与临床杂志, 2006; 13(2)∶219.
6. 　许邦文, 周宁新, 霍宗红. 吸收性止血绫在择期肝部分切除术中的应用 [J]. 中国普外基础与临床杂志, 2002; 9(4)∶276.
7. 　Kraus TW, Mehrabi A, Schemmer P, et al. Scientific evidence for application of topical hemostats, tissue glues, and sealants in hepatobiliary surgery [J]. J Am Coll Surg, 2005; 200(3)∶418.
8. 　Ederle A, Scattolini C, Bulighin G, et al. Does the combination of a human fibrin sealant with ranitidine accelerate the healing of duodenal ulcer? [J]. Ital J Gastroenterol, 1991; 23(6)∶354.
9. 　　Canonico S, Sciaudone G, Pacifico F, et al. Inguinal hernia repair in patients with coagulation problems: prevention of postoperative bleeding with human fibrin glue [J]. Surgery, 1999; 125(3)∶315.
10. 　Davidson BR, Burnett S, Javed MS, et al. Experimental study of a novel fibrin sealant for achieving haemostasis following partial hepatectomy [J]. Br J Surg, 2000; 87(6)∶790.
11. 　詹利永, 王敏, 陆伯豪, 等. 医用胶减少胃癌术后腹腔渗出的随机对照研究 [J]. 中华胃肠外科杂志, 2005; 8（1）∶43.
12. 　张献义, 刘宁青, 吕鹏飞, 等. 医用生物蛋白胶在甲状腺手术中的应用 [J]. 中华普通外科杂志, 2004; 19(8)∶511.
13. 　杨子彬. 生物止血材料——纤维蛋白胶临床应用进展 [J]. 世界医疗器械, 2001; 7(2)∶24.
14. 　Schwartz M, Madariaga J, Hirose R, et al. Comparison of a new fibrin sealant with standard topical hemostatic agents [J]. Arch Surg, 2004; 139(11)∶1148.
15. 　　Capussotti L, Ferrero A, Viganò L, et al. Bile leakage and liver resection: Where is the risk? [J]. Arch Surg, 2006; 141(7)∶690.
16. 　　Eder F, Meyer F, Nestler G, et al. Sealing of the hepatic resection area using fibrin glue reduces significant amount of postoperative drain fluid [J]. World J Gastroenterol, 2005; 11(38)∶5984.
17. 　Hayashibe A, Sakamoto K, Shinbo M, et al. New method for prevention of bile leakage after hepatic resection [J]. J Surg Oncol, 2006; 94(1)∶57.
18. 　　Figueras J, Llado L, Miro M, et al. Application of fibrin glue sealant after hepatectomy does not seem justified: results of a randomized study in 300 patients [J]. Ann Surg, 2007; 245(4)∶536.
19. 　苏怡, 候延文, 高珉之. 纤维蛋白胶生物性能的研究 [J]. 预防医学情报杂志, 2001; 17(6)∶433.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Experimental Study of Fibrin Glue for Preventing and Curing Postoperative Bleeding and Bile Leakage in House-HoldRabbit Following Partial Hepatectomy

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