A comparative study regarding the effect of an intraperitoneal anti-adhesive agent application in left-liver living donors

Abstract

Introduction: The purpose of this study is to evaluate the effect of intraperitoneal anti‐adhesive agent application after living‐donor left hepatectomy, compared with a historical control group. Method: The study group consisted of 220 consecutive living donors who donated a left‐liver graft during the time period between January 2006 and December 2011. The anti‐adhesive agent used was composed of sodium hyaluronate and sodium carboxymethyl cellulose. The historical control group using no anti‐adhesive agent included 220 consecutive left liver donors during the time period between January 1998 and December 2004. Results: Overt gastric stasis requiring fasting was observed in five (2.3%) of the study group and in seven (3.2%) of the control group (p = 0.77). An additional work‐up to determine gastric stasis or prolonged ileus was performed in 17 (7.7%) and 22 (10%) donors, respectively (p = 0.51). Only one donor in the control group underwent laparotomy for intestinal obstruction. No clinical factors, including patient age, sex, body mass index, remnant right liver proportion, skin incision shape, and surgery time, were significant risk factors for gastric stasis or prolonged ileus. No harmful side‐effects of the anti‐adhesive agent were identified. Conclusions: The results of this study revealed that application of an anti‐adhesive agent was not proven to be effective for preventing gastric stasis and ileus. A randomized controlled study will be required in order to demonstrate the true benefits of anti‐adhesive application in left‐liver living donors.