Application of biomedical fibrin glue in laparoscopic fenestration of hepatic cyst

Objective To investigate the feasibility of biomedical fibrin glue in laparoscopic fenestration of hepatic cyst. Methods From January 2012 to June 2018, sixty patients with hepatic cyst undergoing laparoscopic fenestration and drainage in the Eighth Affiliated Hospital of Sun Yat-sen University were prospectively selected. They were randomly divided into the treatment group (sprayed with fibrin adhesive at the residual cavity of cyst and the residual end of the incision margin of cyst wall) and the control group (treated with laparoscopic fenestration and drainage of hepatic cysts), with 30 cases in each group. The operation time, blood loss, extubation time, fasting time, hospitalization days, total expenses, complications rate and serum level of C-reactive protein (CRP), white blood cell count (WBC) and alanine aminotransferase (ALT) during postoperative 1 and 2 days were compared between the two groups. Results (1) Compared with the control group, the operation time, intraoperative bleeding volume, extubation time and fasting time in the treatment group were significantly reduced, with shorter hospitalization days and less total costs, and the differences were statistically significant (t=7.943, 11.932, 25.676, 18.821, 15.823, 3.458, all P<0.001). (2) CRP, WBC and ALT levels of the treatment group were significantly lower than those of the control group at 1 and 2 d after operation (F=52.278, 46.386, 77.924, all P<0.001). (3) There were no bile leakage or ascites and recurrence in 1 patient of the treatment group. In the control group, bile leakage occurred in 2 cases, ascites in 2 cases and recurrence in 3 cases. The incidence of total complications in the treatment group was significantly lower than that in the control group (3.33% vs 23.33%, χ2=5.192, P=0.023). Conclusion The application of biomedical fibrin glue in laparoscopic fenestration of hepatic cyst has a significant effect on closing wounds, promoting tissue healing, preventing bile leakage and ascites, and has no obvious adverse reactions, which is worthy of promotion. Key words: Liver neoplasms; Fibrin tissue adhesive; Hepatic cyst; Drainage