Document Detail

Argon ion beam hemostasis with albumin after liver resection.
MedLine Citation:
PMID:  12034399     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Bleeding is common after liver resection and establishing hemostasis with sutures or argon beam coagulation can be difficult. In our laboratory, concentrated albumin applied to the liver surface before argon beam coagulation improves sealing of the resected surface of the liver, including closure of blood vessels and ducts not generally seen with standard argon beam coagulation. METHODS: Domestic swine underwent heparinization, then laparotomy and wedge resection of the left medial segment of the liver, using finger fracture technique. Blood vessels and ducts 5 mm or greater were ligated. For achieving hemostasis, the animals were randomized to either a control group using argon beam coagulation alone (n = 15) or an albumin group using argon beam coagulation with concentrated 38% albumin (n = 13). After initial hemostasis, the resected liver surfaces were packed for 3 minutes. Repeated applications of argon beam coagulation with or without albumin were performed as needed, followed by 3 minutes of repacking, until complete hemostasis was achieved. Liver functions and blood counts were examined 4 days postoperatively. RESULTS: The albumin group was less likely to require repeat applications of argon beam coagulation than control animals (mean 0.5 versus 1.5 times, P = 0.006). The total time of argon beam coagulation was significantly shorter in the albumin group (mean 90 versus 154 seconds, P = 0.001). CONCLUSIONS: Adding albumin to the liver surface substantially increases the durability of the repaired surface and reduces the time needed to achieve stable hemostasis when compared with standard argon beam coagulation. Further investigations using this technique are warranted.
Ronald F Wolf; Hua Xie; John Petty; Jeff S Teach; Scott A Prahl
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  American journal of surgery     Volume:  183     ISSN:  0002-9610     ISO Abbreviation:  Am. J. Surg.     Publication Date:  2002 May 
Date Detail:
Created Date:  2002-05-29     Completed Date:  2002-06-26     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370473     Medline TA:  Am J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  584-7     Citation Subset:  AIM; IM    
Providence St. Vincent Hospital, 9155 SW Barnes Rd., Suite 940, Portland, OR 97219, USA.
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MeSH Terms
Albumins / therapeutic use*
Argon / therapeutic use*
Blood Loss, Surgical / prevention & control
Hemostasis, Surgical / instrumentation,  methods*
Laser Coagulation / methods*
Liver / surgery*
Models, Animal
Postoperative Hemorrhage / prevention & control
Random Allocation
Reg. No./Substance:
0/Albumins; 7440-37-1/Argon

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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