Carrier-bound fibrin sealant compared to oxidized cellulose application after liver resection.

objectiveThe aim of the study was to compare the incidence of post-operative complications between those patients that received TachoSil to the transection surface of the liver vs. those that received Surgicel.

methodsRetrospective study of a prospective database in a tertiary hospital. Primary endpoints were overall complications. Secondary endpoints were liver surgery-specific composite endpoint, major complications and hospital stay. Uni- and multivariate analysis of predictive factors for complications and subgroup analysis were performed.

resultsOne hundred thirty-three liver resections were performed between 9 November 2007 and 2 November 2011: 64 with TachoSil and 69 with Surgicel application. Both groups were equivalent concerning demographic, clinical and major intra-operative data. No significant differences were observed in overall complication rate (62.5% vs. 62.3%), liver surgery-specific composite endpoint (12.5% vs. 18.8%), major complication rate (18.7% vs. 24.6%) and median hospital stay (13 vs. 10 days) for TachoSil and Surgicel application, respectively. Predictive factors for complications in multivariate analysis were: American Society of Anesthesiology Score ≥3 and duration of surgery >240 min. Subgroup analysis found a reduced complication rate with TachoSil for major hepatectomy.

conclusionThe results of the present study suggest that the routine use of TachoSil after a liver resection does not reduce the overall complication rate compared with Surgicel application. However, TachoSil may be beneficial in a major hepatectomy.