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Year 2016 Vol. 24 No 4
GENERAL & SPECIAL SURGERY
I.S. ZHAVORONOK 1, G.G. KONDRATENKO 1, V.N. GAPANOVICH2, A.V. ESEPKIN 3, A.D. KARMAN 1
THE ARREST OF BLEEDING FROM THE LIVER PARENCHYMA BY USING AN INORGANIC HEMOSTATIC AGENTS
EE "Belarusian State Medical University"1,
ME "Minsk 10th City Clinical Hospital"3
The Republic of Belarus
Objectives. To study an application opportunity of a new local haemostatic agent “Gamastat” in the combination with a selective electrocoagulation of particular bleeding vessels of the gall bladder bed during cholecystectomy.
Methods. The comparative study of treatment results of patients (n=77), divided into two groups has been conducted. In the main group (n=45) of patients to stop bleeding from the gallbladder bed a haemostatic agent “Gamastat” and a selective coagulation only of particular bleeding vessels have been applied during surgery versus a standard technique of a continuous electrocoagulation of the gall bladder bed in cholecystectomy, used in the control group (n=32). A bleeding arrest after treating of the liver wound surface with local haemostatic agents or electrocoagulation was registered; dynamics of changes of the blood cytological and biochemical indicators and plasma haemostasis parameters were studied preoperatively and on the 3rd postoperative day.
Results. The complete haemostasis at “Gamastat” application and a selective coagulation of particular bleeding vessels have been achieved in a greater number of cases (88,9%), than at the application of a continuous electrocoagulation of the gall bladder bed (75% of cases).
If haemostasis by the abovementioned methods was not achieved, gall bladder bed bleeding was stopped by the use of more extensive electrocoagulation of the gall bladder bed and the plate “Tachoñomb”. The combination of “Gamastat” application and a selective electrocoagulation of bleeding vessels in the area of the gall bladder bed provides less hepatic parenchyma coagulation injury as evidenced by a reduced manifestation of hepatocyte cytolysis versus a continuous electrocoagulation.
Conclusion. In the main group the expressed local haemostatic activity of “Gamastat” has been established as well as reliably insignificant manifestation of electrocoagulative injury of the liver accompanied by less marked growth of indicators of cytolisis AlAt and AsAt in comparison with those in patients of the control group. Negative effects of “Gamastat” application were not observed.
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220116, Republic of Belarus, Minsk, Dzerzhinskiyi pr., d. 83, Belarusian State Medical University, chair of surgical diseases N1. Tel: + 375 29 624-98-37
Zhavoronok Irina Sergeevna
Zhavoronok I.S. Post-graduate student, EE "Belarusian State Medical University", chair of surgical diseases N1.
Kondratenko G.G. MD, Professor, Head, EE "Belarusian State Medical University", chair of surgical diseases N1.
Gapanovich V.N. MD, Director, UE "Lotios".
Esepkin A.V. Head, ME "Minsk 10th city clinical hospital", surgical department N1.
Karman A.D. PhD, Ass. Professor, EE "Belarusian State Medical University", chair of surgical diseases N1.