The application of anti-adhesive agents in hepatic resection: A comprehensive review for the transplant surgeon

Postoperative adhesions following hepatic resection are a significant cause of morbidity, leading to complications such as small bowel obstruction and chronic pain.However, in the context of liver surgery, these adhesions present a unique and formidable challenge, particularly when a subsequent liver transplantation may be necessary.Adhesions from a prior resection can dramatically increase the difficulty, operative time, and blood loss associated with the transplantation procedure, thereby increasing patient morbidity.Furthermore, with the prominence of living donor liver transplantation, minimizing adhesion formation in healthy donors is an ethical and clinical imperative.This review provides a comprehensive analysis of currently available anti-adhesive agents, including films, gels, and solutions.We evaluate the evidence for their efficacy and safety in hepatic resection and, most importantly, explore their critical applications and potential benefits in the specific settings of liver transplantation recipients and living donors.Finally, we propose future research directions to establish best practices for the use of these agents to improve outcomes in the field of liver transplantation.