Novel use of Absorbable Modified Polymer (AMP®); EndoClot™ as an adjunct in the management of bleeding from the liver bed during laparoscopic cholecystectomy.

Abstract

BACKGROUND: Serious intra-operative bleeding during laparoscopic cholecystectomy is rare with an incidence of less than 2% (Tuveri and Tuveri [2007]; Marakis et al. [2007]; Vagenas et al. [2006]). The incidence is high in patients with liver disease, specifically, in cirrhosis with portal hypertension (Kaushik [2010]). Absorbable Modified Polymer (AMP®) is a polysaccharide which is sprayed on to a bleeding surface and acts by absorbing fluid and increasing the concentration of platelets, red blood cells and clotting factors at the site. Although short case series of using AMP in gastrointestinal bleeding are available (Halkerston et al. [2013]; Patel et al. [2014]) this is the first report of its intra-peritoneal use.