Korean J Hepatobiliary Pancreat Surg.  2014 Feb;18(1):26-28. 10.14701/kjhbps.2014.18.1.26.

A comparative study regarding the effect of an intraperitoneal anti-adhesive agent application in left-liver living donors

• Park CS
• Hwang S
• Ahn CS
• Kim KH
• Moon DB
• Ha TY
• Song GW
• Jung DH
• Park GC
• Park HW
• Park YH
• Kang SH
• Jung BH
• Lee SG

• KMID: 1890077
• DOI: http://doi.org/10.14701/kjhbps.2014.18.1.26

Abstract

BACKGROUNDS/AIMS
After left-sided hepatectomy due to a living donor, the stomach can become adhered to the hepatic cut surface. An unwanted gastric stasis can occur. For prevention of such gastric adhesion and laparotomy-associated adhesive ileus, some anti-adhesive agents have been developed for intra-abdominal application. The purpose of this study is to evaluate the effect of an intraperitoneal anti-adhesive agent application compared with a historical control group.
METHODS
The study group consisted of 220 consecutive living donors who donated a left-liver graft during the time period between January 2006 and December 2011. The anti-adhesive agent which was used was composed of sodium hyaluronate and sodium carboxymethyl cellulose. The historical control group which used no anti-adhesive agent included 220 consecutive left-liver donors during the time period between January 1998 and December 2004.
RESULTS
An overt gastric stasis which required fasting was observed in 5 subjects (2.3%) in the study group and in 7 subjects (3.2%) in the control group (p=0.77). An additional work-up to determine gastric stasis or prolonged ileus was performed in 17 (7.7%) and 22 (10%) donors, respectively (p=0.51). Only one donor in the control group underwent a laparotomy for an intestinal obstruction. No clinical factors such as patient age, sex, body mass index, remnant right liver proportion, shape of skin incision, and duration of surgery were significant risk factors of gastric stasis or prolonged ileus. No harmful side-effects of the anti-adhesive agent were identified.
CONCLUSIONS
As a result of this study, the application of an anti-adhesive agent could not be proved as to be effective for prevention of gastric stasis and postoperative ileus. A further randomized and controlled study will be required to demonstrate the real benefits of an anti-adhesive application in left-liver living donors.

Keyword

Living-donor liver transplantation; Left hepatectomy; Gastric stasis; Ileus

MeSH Terms

Adhesives
Body Mass Index
Carboxymethylcellulose Sodium
Fasting
Gastroparesis
Hepatectomy
Humans
Hyaluronic Acid
Ileus
Intestinal Obstruction
Laparotomy
Liver
Living Donors*
Risk Factors
Skin
Sodium
Stomach
Tissue Donors
Transplants
Adhesives
Carboxymethylcellulose Sodium
Hyaluronic Acid
Sodium

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