Evaluation of novel hemostatic agents in controlling intraoperative bleeding during liver resections

Abstract

Background: Intraoperative bleeding during liver resections remains a major surgical challenge, contributing to increased transfusion requirements, longer operative times, and postoperative complications.

Objective: To evaluate the efficacy of novel hemostatic agents in reducing intraoperative bleeding and improving perioperative outcomes during liver resections.

Methods: This prospective observational study was conducted at Organ transplant unit Pir Abdul Qadir shah jeelani institute of Medical sciences/ Gambat Medical college from May 2023 to august 2024. It included 154 patients undergoing elective liver resections, divided into two groups: Group A (n=76) managed with conventional hemostasis and Group B (n=78) managed with adjunctive novel hemostatic agents. Data on demographics, intraoperative parameters, transfusion requirements, postoperative complications, hospital stay, and 30-day mortality were collected.

Results: Patients in the novel agent’s group had significantly lower intraoperative blood loss (420 ± 150 mL vs. 610 ± 210 mL, p<0.001) and reduced transfusion requirements (16.7% vs. 35.5%). Operative time was slightly shorter in Group B (185 ± 35 min vs. 198 ± 42 min, p=0.048). Postoperative complications, including bile leakage (7.7% vs. 15.8%) and surgical site infections (7.7% vs. 11.8%), were lower in Group B but not statistically significant. Mean hospital stay was significantly reduced with novel agents (7.2 ± 2.1 days vs. 8.4 ± 2.7 days, p=0.021).

Conclusion: It is concluded that novel hemostatic agents provide effective adjuncts in liver resections, significantly reducing blood loss, transfusion needs, and hospital stay. Although trends toward fewer complications were observed, further large-scale multicenter trials and cost-effectiveness analyses are necessary before routine adoption.