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Langenbeck's Archives of Surgery

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01-10-2014 | Review Article

Fibrin sealants and topical agents in hepatobiliary and pancreatic surgery: a critical appraisal

Authors: Erin M. Hanna, John B. Martinie, Ryan Z. Swan, David A. Iannitti

Published in: Langenbeck's Archives of Surgery | Issue 7/2014

Abstract

Introduction

Fibrin sealants and topical hemostatic agents have been used extensively in hepatobiliary and pancreatic (HPB) surgery to promote coagulation and clot formation decreasing the need for allogeneic blood transfusion and to act as tissue sealants, ideally preventing biliary, enteric, and pancreatic leaks.

Results

Current literature has demonstrated some favorable outcomes using many different products for application in the field of HPB surgery. However, critical findings exist demonstrating lack of reproducible efficacy or benefit. In all, many clinical trials have demonstrated effectiveness of fibrin sealants and other agents at reducing the need for intraoperative and postoperative blood transfusion. Ability to effectively seal tissues providing biliostatic effect or preventing postoperative fistula formation remains debated as definitive evidence is lacking.

Conclusions

In the following invited review, we discuss current literature describing the use of topical agents and fibrin sealants in liver and pancreas surgery. We summarize major contemporary clinical trials and their findings regarding the use of these agents in HPB surgery and provide evidence from the preclinical literature as to the translation of these products into the clinical arena.

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Title: Fibrin sealants and topical agents in hepatobiliary and pancreatic surgery: a critical appraisal
Authors: Erin M. Hanna
John B. Martinie
Ryan Z. Swan
David A. Iannitti
Publication date: 01-10-2014
Publisher: Springer Berlin Heidelberg
Published in: Langenbeck's Archives of Surgery / Issue 7/2014
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-014-1215-5

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Fibrin sealants and topical agents in hepatobiliary and pancreatic surgery: a critical appraisal

Abstract

Introduction

Results

Conclusions

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Springer Medicine

Abstract

Introduction

Results

Conclusions

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