Abstract
The aim of this study was to produce a meta-analysis including only prospective and randomized studies to know real effect using hemostatic sealants on the resection edge after elective hepatic resection, especially regarding biliary fistula and hematoma.
Highlights
The improvements in surgical techniques and anaesthetic management have reduced postoperative mortality in hepatic surgery in the last years, reaching rates between 0.7% and 2.6% [1]
Articles comparing over 2 different hemostatic agents, or studies with no control group were excluded, as well as non-randomized prospective trials
High quality studies exclusively analysing its use against using no hemostatic agent to control bleeding and biliary leaks remain few
Summary
The improvements in surgical techniques and anaesthetic management have reduced postoperative mortality in hepatic surgery in the last years, reaching rates between 0.7% and 2.6% [1]. Morbidity due to the edge of the hepatic section, such as hematomas and biliary fistulas, remains a grievous problem that in the end consumes more resources, leads to longer hospital stays and even increases mortality [2]. The use of biological hemostatic and sealing agents over the edge of the liver resection has been intensified for over 30 years, with the aim of decreasing the need for blood transfusion, decreasing bleeding and biliary fistulas [6]. Over half of the centers performing hepatic surgery systematically employ these agents, with no specific indications nor scientific evidence endorsing their use [7]
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