A GELFOAM EMBOLIZATION METHOD FOR BLEEDINGAFTER LAPAROSCOPIC LIVER BIOPSY

概要

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Intra-abdominal bleeding and bile peritonitis are major complications of liver biopsy through laparoscopy. In this study, a gelfoam embolization method was applied for prevention of bleeding or bile leakage from biopsy wounds of the liver. Liver biopsy through laparoscopy has been performed in 69 cases from Oct, 1982 to Jun, 1983. In 49 out of 69 cases, the gelfoam embolization method was used for hemostasis of biopsy wounds, and in 20 cases the conventional method was used. These two methods were compared in regard to hemostatic effect, influence on liver function tests, ultrasonography and CT of the liver. The gelfoam embolization method was considered to be superior to the conventional method from the standpoint of hemostatic effect. But, some side-effects were seen such as right hypochondralgia, fever, leucocytosis, positive CRP, and development of space occupying lesions. Since these side-effects were considered to occur due to portal thrombosis or hematoma in the liver, which were formed by over-dose injection of the gelf oam, they would be prevented by reducing the dose of gelf oam as small as possible. Hemostasis using gelfoam is easy and secure even in a patient with advanced liver cirrhosis, and it would be possible to extend the application of laparoscopic liver biopsy by this hemostatic method.
社団法人日本消化器内視鏡学会の論文