Blunt liver injuries. Resection vs. nonresection for primary hemostasis.
The records from 60 surgically treated cases of blunt liver injury during a 20-year period were reviewed. Preoperative shock was present in 26 (43%) of the patients. The severity of liver injury was graded 1-3. All of the 23 grade 1 injuries were managed with simple surgical techniques, with no deaths related to the hepatic trauma and only one hepatic complication. Of the 32 patients with grade 2 injury, 12 were managed with and 20 without liver resection. Resection did not increase mortality, morbidity, blood loss or hospital stay. Local hepatic bleeding complications were significantly rarer after resection. Reoperation for local hepatic complication was required three times as often in the nonresection as in the resection group. Only one of the five patients with grade 3 liver injury survived. The overall mortality in the series was 20%. Primary liver resection is suggested as a good option in the management of deep liver laceration.
Second Department of Surgery, Helsinki University Central Hospital, Finland.
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Leppäniemi
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006487:Hemostasis; D006801:Humans; D008099:Liver / Q000293:injuries* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality; D012189:Retrospective Studies; D014949:Wounds, Nonpenetrating / Q000097:blood / Q000601:surgery*