• Andrea Frilling, Gregor A Stavrou, Hans-Jörg Mischinger, Bernard de Hemptinne, Mogens Rokkjaer, Jürgen Klempnauer, Anders Thörne, Beat Gloor, Susanne Beckebaum, Mohamed F A Ghaffar, and Christoph E Broelsch.
• Department of General Surgery and Transplantation, University Hospital of Essen, Hufelandstrasse 55, 45147 Essen, Germany. frilling@uni-essen.de
• Langenbecks Arch Surg. 2005 Apr 1;390(2):114-20.

Background And AimsA new carrier-bound fibrin sealant, TachoSil, is expected to be efficacious and safe as a haemostatic treatment in hepatic resection.DesignA prospective, randomised, open and controlled multicentre trial with intraoperative as well as postoperative assessment of efficacy and a 1 month follow-up period.SettingTertiary care centres.Patients/MethodsOne hundred and twenty-one patients requiring secondary haemostasis during planned liver resection. Patients with coagulation disorders and patients with persistent major bleeding after primary haemostatic measures were excluded.InterventionApplication of either carrier-bound fibrin sealant (n=59) or argon beamer (argon beam coagulator) (n=62) as secondary haemostatic treatment.Main Outcome MeasureTime to intraoperative haemostasis.ResultsThere was a significant superiority of TachoSil over argon beamer with regard to time to haemostasis (3.9 min, median 3.0, range 3-20 min vs 6.3 min, median 4.0, range 3-39 min) (P=0.0007). Haemoglobin concentration of drainage fluid was significantly lower on day 2 after surgery in TachoSil patients (1.1 mmol/l) than in argon beamer patients (2.3 mmol/l) (P=0.012). Overall, the frequency and causality of adverse events did not differ between the two treatment groups.ConclusionTachoSil is superior to argon beamer in obtaining effective and fast intraoperative haemostasis. The safety data show TachoSil to be tolerable and safe for haemostatic treatment in liver resection.

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