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Patients were excluded from study participation if bleeding sites were parenchymal or anastomotic, or if the surgeon determined that there were intraoperative findings that could have precluded the conduct of the study. Once intraoperative eligibility was confirmed, patients were randomized on a 1:1 basis to receive either fibrin sealant or absorbable hemostat (control group) as an adjunct for hemostasis once conventional surgical techniques were considered impractical or ineffective. The time at which the randomization envelope was opened was recorded as T0. For patients randomized to receive fibrin sealant, the fibrin sealant was dripped or sprayed onto the TBS; for patients randomized to the absorbable hemostat group, absorbable hemostat was directly [https://en.wikipedia.org/wiki/Adenine Adenine] applied with manual compression. At [http://www.selleckchem.com/screening/selective-library.html Target Selective Inhibitor Library chemical structure] 4, 7, and 10 minutes following randomization, bleeding at the TBS was evaluated. The primary effectiveness endpoint was the achievement of hemostasis at 10 minutes. The secondary effectiveness endpoints were the hemostasis outcome at 4 and 7 minutes, the incidence of complications that were potentially related to bleeding, and the incidence of treatment failures (defined as the presence of bleeding at the TBS 10 minutes postrandomization or brisk bleeding that required use of additional hemostatic measures during the 10-minute period). The absolute time to hemostasis was recorded for each patient. Adverse events were also recorded as they occurred. Statistical Analysis Analyses of effectiveness measures were conducted using the intent-to-treat population, which included all randomized patients. Analyses of safety measures were conducted using all patients who were randomized and received treatment. Absence of bleeding at the TBS at 4, 7, and 10 minutes following randomization, the incidence of treatment failures, and the incidence of complications that [http://www.selleckchem.com/products/gw3965.html GW3965] were potentially related to bleeding were analyzed. The proportion of patients in each treatment group who achieved hemostatic success was calculated, and a two-sided 95% confidence interval (CI) was constructed to evaluate the ratio of proportions of success (relative risk [RR]) between the treatment groups (fibrin sealant to absorbable hemostat) using a previously described method.18 If the lower limit of the 95% CI was > 0.80, the fibrin sealant was determined to be noninferior to the absorbable hemostat. If the lower limit was > 1.0, this was considered to be evidence for the superiority of the fibrin sealant in terms of statistical significance at the 5% level (P