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A cost-effective analysis of fibrin sealants versus no sealant following open right hemihepatectomy for colorectal liver metastases

Lookup NU author(s): Professor Sanjay PandanaboyanaORCiD

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Abstract

© 2014 Royal Australasian College of SurgeonsBackground: There is paucity of data regarding the cost-effectiveness of fibrin sealants during liver surgery. This study aimed to assess the cost-effectiveness of fibrin sealants following right hemihepatectomy for colorectal liver metastases. Method: A prospectively maintained database between 2004 and 2013 was reviewed to identify patients who underwent a right hemihepatectomy with and without fibrin sealant application. Perioperative and post-operative outcomes were analysed to assess its cost-effectiveness. Results: One hundred and sixty-three right hemihepatectomies were performed, of which 79 were in the fibrin sealant treatment group and 84 were in the no sealant group. No difference was seen between fibrin sealant and no sealant with regard to bile leak (P = 0.366), intra-abdominal collections (P = 0.200) and overall post-operative complications (P = 0.480). Operating costs were significantly cheaper in the no sealant group (P = 0.010). There was no difference seen in median post-operative stay between fibrin sealant versus no treatment (8 versus 9 days, P = 0.327), median total bed cost (£3900 versus £4300, P = 0.400), mean transfusion cost per patient (P = 0.201) and overall cost (£6706.15 versus £6555.80, P = 0.792). Conclusion: Fibrin sealant application to cut surface during liver surgery confers no cost benefit and their routine use may not be recommended.


Publication metadata

Author(s): Pandanaboyana S, Bell R, Shah N, Lodge JPA, Hidalgo E, Toogood GJ, Prasad KR

Publication type: Article

Publication status: Published

Journal: ANZ Journal of Surgery

Year: 2017

Volume: 87

Issue: 6

Pages: E11-E14

Online publication date: 30/12/2014

Acceptance date: 04/11/2014

ISSN (print): 1445-1433

ISSN (electronic): 1445-2197

Publisher: Blackwell Publishing

URL: https://doi.org/10.1111/ans.12948

DOI: 10.1111/ans.12948

PubMed id: 25641546


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