Abstract
BackgroundBiloma, 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).MethodsWe 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.ResultsIn 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.ConclusionsIt 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.
Highlights
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
Our primary endpoint is to test the safety and feasibility of Glubran2 during surgical liver resection in patients with Colorectal liver metastases (mCRC) previously treated with chemotherapy; as secondary endpoint we selected the utility of this agent to prevent biloma or biliary fistula to assess its biliostatic effect
Study population We searched, in the surgical database of the National Cancer Institute of Naples, all patients who underwent liver resection for mCRC from January 2013 to December 2018 and we found a total of 510 patients
Summary
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 (Glubran). The only curative option for patients with colorectal liver metastases (mCRC) enabling 5-year overall survival rates of 50 %, is hepatic resection [1, 2]. Effective oxaliplatin- and irinotecan-based chemotherapy protocols associated with targeted agents have significantly improved response rates, conversion to resectability and long-term survival in mCRC patients [1]. Our primary endpoint is to test the safety and feasibility of Glubran during surgical liver resection in patients with mCRC previously treated with chemotherapy; as secondary endpoint we selected the utility of this agent to prevent biloma or biliary fistula to assess its biliostatic effect
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