Fourteen pigs underwent left-sided hepatectomy. The resection was performed with a linear stapling device and the pigs were randomised to either Surgicel ® reinforced resection lines or not. The median time required for resection was 25 min (range 17-30) in the Surgicel® reinforced group compared to 30 min (range 21-41) in the stapled group. This difference was, however, not statistically significant (p=0.053).The postoperative haemoglobin value was lower in the stapled group compared to the Surgicel® reinforced group 69 g/1 (range 42-85) versus 82 g/1 (range 78-90) (p=0.018). The estimated blood losses by weighing the compresses were 287 ml (range 166-379) for the stapled group and 204 ml (range 152-264) for the Surgicel® reinforced group (p=0.053). The median number of additional haemostatic sutures in the Surgicel® reinforced group was 7 (range 3-11) and in the stapled group 10 (range 5-15) (p=0.038).The haemoglobin value was similar in the two groups week postoperatively; 100 g/1 (range 87-104) and 102 g/1 (range 95-114), p=0.27, in the stapled group and the Surgicel® reinforced group, respectively. In the stapled group reinforced with the Surgicel® there was one postoperative death. In the solely stapled group there was no postoperative death (p=0.5). Four out of six pigs in the Surgicel® group had massive adhesions to the resection lines. One of these six pigs was sacrificed postoperatively as it was ill and had small bowel obstruction secondary to Surgicel® induced adhesions. On the other hand, no adhesions were seen in the solely stapled pigs (p=0.09). At this point, we can not recommend the use of Surgicel® to reinforce resection lines at stapled liver resection in the clinical situation, because of the high frequency of adhesions this material creates.
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