[Human fibrin glue in the treatment of residual parenchymal surface after total pericystectomy for hepatic echinococcus].

The aim of this study was to evaluate the presumed efficacy of fibrin sealant in limiting bleeding and biliary leakage from liver residual surface after total pericystectomy for hydatid disease. Forty-five patients (group A) who underwent total pericystectomy in our Institution from 1986 to 1995 and liver residual surface treated with conventional techniques and fibrin sealant for control of haemorrhage and bile leakage were selected. A control group (B) was carefully selected, matching the main characteristics of patients in group A: it consisted of 44 patients, who underwent total pericystectomy from 1981 to 1993 and in which fibrin sealant was not used. Postoperative hospital stay, morbidity, mortality, abdominal drainage discharge, perioperative variations of hemoglobin and hematocrit readings and the need for postoperative blood transfusion were evaluated in the two groups. A statistical analysis was performed. We found no statistical significance for the considered parameters in the two groups. Markedly no significative difference was found in morbidity, abdominal drainage discharge and need for postoperative blood transfusion. Our results do not allow a definite assessment of the actual role of fibrin sealant in rising efficacy on control of bleeding and biliary leakage from residual liver surface to total pericystectomy obtained with conventional haemostatic techniques. We believe that a previously planned controlled prospective trial could give the needed further elements to precisely evaluate the role of fibrin sealant in the surgical treatment of hydatid disease of the liver.