Evaluation of the biliostatic properties of modern topical hemostatic agents used in liver surgery

Aim. To evaluate the biliostatic properties of modern topical hemostatic agents used in liver surgery in experiment.

Materials and methods. The analysis of applied topical hemostatics in medical institutions of Chuvash Republic with liver resection is performed. A number of studies on the evaluation of adhesion properties in Vistar rats weighing 180-200 g were carried out using a device for determining the hermeticity of the liver stump by hydroporation. A comparative evaluation of the elasticity and adhesion strength of hemostatic agents was carried out. The polyurethane glue for medical purposes was developed and studied in the experiment.

Results. To prevent bleeding and bile leakage, the most commonly used adhesive compositions are "Bioglue", "Tissucol", a gemostatic sponge, "Tachocomb", a gelatin sponge "Spongostan", a cellulose plate "Sergisel". The adhesive adhesives "Bioglue", "Tissucol" and the hemostatic sponge "Tachocomb" and the polyurethane composition of medical purpose with an adhesive strength of more than 600 mm of water column (mmW) at p <0.05 have the highest adhesion properties at p <0,05, based on the experimental. It has been established that a glue composition "Bioglue" and a polyurethane adhesive composition have a significant adhesive strength (more than 4.6 kgf / cm2) and elasticity (more than 140%).

Conclusions. For the reliable prevention of bile leakage after liver resection, it is necessary to use topical hemostatic agents with an adhesive strength of more than 600 mm. water column. More preferable in this case is the use of adhesive compositions; they have good elasticity, viscosity and form a large area of contact with the bile ducts as compared with the plates and sponges.