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首页> 美国卫生研究院文献>ISRN Surgery >Hemostatic Agents in Hepatobiliary and Pancreas Surgery: A Review of the Literature and Critical Evaluation of a Novel Carrier-Bound Fibrin Sealant (TachoSil)
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Hemostatic Agents in Hepatobiliary and Pancreas Surgery: A Review of the Literature and Critical Evaluation of a Novel Carrier-Bound Fibrin Sealant (TachoSil)

机译：肝胆胰外科手术中的止血药：文献综述和新型载流纤维蛋白密封剂（TachoSil）的关键评价

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Background. Despite progress in surgical techniques applied during hepatobiliary and pancreas (HPB) surgery, bleeding and bile leak remain significant contributors to postoperative mortality and morbidity. Topical hemostatics have been developed and utilized across surgical specialties, but data regarding effectiveness remains inconsistent and sparse in HPB surgery. Methods. A comprehensive search for studies and reviews on hemostatics in HPB surgery was performed via an October 2011 query of Medline, EMBASE, and Cochrane Library. In-depth evaluation of a novel carrier-bound fibrin sealant (TachoSil) was also performed. Results. The literature review illustrates multiple attempts have been made at developing different topical hemostatics and sealants to aid in surgical procedures. In HPB surgery, efforts have been directed at decreasing bleeding, biliary leakage, and pancreatic fistula. Conflicting scientific evidence exists regarding the effectiveness of these agents. Critical evaluation of the literature demonstrates TachoSil is a valuable tool in achieving hemostasis, and possibly biliostasis and pancreatic fistula prevention. Conclusion. While progress has been made in topical hemostatics for HPB surgery, an ideal agent has not yet been identified. TachoSil is promising, but larger randomized, controlled clinical trials are required to more fully evaluate its efficacy in reducing bleeding, biliary leakage, and pancreatic fistulas in HPB surgery.
机译：背景。尽管在肝胆和胰腺（HPB）外科手术中采用的外科手术技术取得了进步，但出血和胆汁泄漏仍是导致术后死亡率和发病率的重要因素。局部止血药已在各个外科专业领域得到开发和利用，但有关有效性的数据在HPB手术中仍然不一致且稀疏。方法。通过2011年10月对Medline，EMBASE和Cochrane Library的查询，对HPB手术止血剂的研究和评价进行了全面搜索。还进行了新型载体结合的血纤蛋白封闭剂（TachoSil）的深入评估。结果。文献综述表明在开发不同的局部止血剂和密封剂以辅助外科手术方面已进行了多次尝试。在HPB手术中，已经致力于减少出血，胆漏和胰瘘。关于这些药物的有效性存在科学上相互矛盾的证据。对文献的严格评估表明，TachoSil是实现止血，可能预防胆汁淤积和预防胰瘘的重要工具。结论。虽然用于HPB手术的局部止血剂已经取得进展，但尚未确定理想的药物。 TachoSil是有希望的，但是需要更大规模的随机对照临床试验才能更全面地评估其在HPB手术中减少出血，胆漏和胰瘘的功效。

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