Management of severe hepatic trauma by two-stage total hepatectomy and subsequent liver transplantation.
Even today major hepatic trauma remains a formidable surgical challenge with considerable deaths from exsanguination. Apart from conservative operative techniques that allow successful management in most cases, liver transplantation may be indicated in a more severe injury. This is a report on a patient with massive, unsalvageable liver trauma on whom the first two-staged procedure was successfully performed. After total hepatectomy as the first step and a prolonged anhepatic period of more than 14 hours, liver replacement by an allograft was carried out in a second operation. The patient recovered completely from the potentially lethal hepatic trauma and is alive more than 17 months later.
Ringe
B
B
Medizinische Hochschule Hannover, Klinik für Abdominal- und Transplantationschirurgie, Federal Republic of Germany.
Pichlmayr
R
R
Ziegler
H
H
Grosse
H
H
Kuse
E
E
Oldhafer
K
K
Bornscheuer
A
A
Gubernatis
G
G
D000063:Accidents, Traffic; D000293:Adolescent; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D008099:Liver / Q000293:injuries*; D016031:Liver Transplantation / Q000379:methods; D014184:Transplantation, Homologous