Hemostasis after liver resection improves after single application of albumin and argon beam coagulation.

摘要

BACKGROUND: Bleeding from the liver surface is common after hepatic resection. Animal studies have demonstrated superiority of argon beam coagulation (ABC) and 38% human serum albumin when applied together after partial liver resection when compared to ABC alone. There are no data addressing the combination of albumin and argon beam coagulation (ABCA) applied to the bleeding liver after resection in humans. The aim of this study was to evaluate the safety and efficacy of ABCA on hemostasis when applied to the surface of the liver remnant post-hepatic resection. METHODS: Ten patients underwent liver resection and were treated with ABCA immediately after the liver was divided. The liver surface was coated with albumin and ABC applied simultaneously, the liver was covered with gauze for 3 min, and ABCA was repeated if necessary. Number of rebleeding episodes requiring re-application of ABCA, time of ABCA application, overall blood loss, and liver functions were monitored. Patients were followed for at least 6 months. RESULTS: Nine of 10 patients required a single application of ABCA, and one patient required two treatments. Average time of ABC use was 5 +/- 3 min. Median blood loss was 230 ml. Liver functions returned to near normal within 4 days of resection. CONCLUSIONS: ABCA performed well with respect to hemostatic properties, much like previous observations in animal studies. Further clinical trials are justified using this technique.