Objective:Adhesion barriers have not traditionally been used during laparoscopic cholecystectomy(lapchole),and so there are no data confirming the safety of the dextrin hydrogel adhesion barrier(AdSpray®)for the ...Objective:Adhesion barriers have not traditionally been used during laparoscopic cholecystectomy(lapchole),and so there are no data confirming the safety of the dextrin hydrogel adhesion barrier(AdSpray®)for the use during lap-chole.The aim of this prospective study is to investigate the safety of AdSpray®for elective lap-chole.Methods:Between July 2019 and March 2021,we conducted a prospective study at Saiseikai Kumamoto Hospital to assess the safety of applying AdSpray®around the hepatoduodenal ligament,liver surface,and port area after extraction of the gallbladder during elective lap-chole.We assessed patient morbidity,mortality,and laboratory data on postoperative day 1 and at the outpatient follow-up visit.Results:A total of 100 patients(43 men,57 women)received AdSpray®application during elective lapchole at our institution.The mean patient age was 56.5±14.8 y,and the mean body mass index was 25.1±4.8 kg/m2.Preoperative gallbladder drainage was performed in 3(3.0%)patients as conservative treatment for acute cholecystitis.The mean operative time was 91.7±35.1 min,and the median blood loss was 5 mL(range,5e120 mL).Intraoperative gallbladder perforation was observed in 4.0%of patients(n=4).There was no intraoperative bile duct injury.One(1.0%)patient had a postoperative subhepatic fluid collection without bacterial infection.The mean white blood cell count and C-reactive protein level was significantly elevated on postoperative day 1 but returned to preoperative levels by the time of the follow-up visit.All patients were successfully discharged after surgery,and the median postoperative hospital stay was 2 d(range,2e9 d).Conclusion:Applying AdSpray®during elective lap-chole is safe,with an acceptable rate of postoperative complications.展开更多
文摘Objective:Adhesion barriers have not traditionally been used during laparoscopic cholecystectomy(lapchole),and so there are no data confirming the safety of the dextrin hydrogel adhesion barrier(AdSpray®)for the use during lap-chole.The aim of this prospective study is to investigate the safety of AdSpray®for elective lap-chole.Methods:Between July 2019 and March 2021,we conducted a prospective study at Saiseikai Kumamoto Hospital to assess the safety of applying AdSpray®around the hepatoduodenal ligament,liver surface,and port area after extraction of the gallbladder during elective lap-chole.We assessed patient morbidity,mortality,and laboratory data on postoperative day 1 and at the outpatient follow-up visit.Results:A total of 100 patients(43 men,57 women)received AdSpray®application during elective lapchole at our institution.The mean patient age was 56.5±14.8 y,and the mean body mass index was 25.1±4.8 kg/m2.Preoperative gallbladder drainage was performed in 3(3.0%)patients as conservative treatment for acute cholecystitis.The mean operative time was 91.7±35.1 min,and the median blood loss was 5 mL(range,5e120 mL).Intraoperative gallbladder perforation was observed in 4.0%of patients(n=4).There was no intraoperative bile duct injury.One(1.0%)patient had a postoperative subhepatic fluid collection without bacterial infection.The mean white blood cell count and C-reactive protein level was significantly elevated on postoperative day 1 but returned to preoperative levels by the time of the follow-up visit.All patients were successfully discharged after surgery,and the median postoperative hospital stay was 2 d(range,2e9 d).Conclusion:Applying AdSpray®during elective lap-chole is safe,with an acceptable rate of postoperative complications.
