Liver injuries in sydney: a 20-year experience.
One hundred and twenty consecutive liver injuries treated at the Royal Prince Alfred Hospital have been studied prospectively. The overall mortality of 17.5% and the mortality for blunt injury of 23% compare quite favourably with figures in other reported series of similar injuries. The surgeon who treats liver injury must have a repertoire of procedures appropriate for different circumstances and must remain flexible in his approach. Simple suture haemostasis and the provision of adequate drainage will cope with most injuries. Debriding resections are safe, allow adequate haemostasis to be achieved, and give reasonably good access to the retrohepatic vena cava and hepatic veins. Formal lobectomy is very rarely indicated. Drainage of the common bile duct is to be avoided, but cholecystostomy has some marginal advantages and appears safe. The problems of retrohepatic vena caval injury and major hepatic vein tears have not all been solved.
D000328:Adult; D001315:Australia; D001803:Blood Transfusion; D005260:Female; D006488:Hemostasis, Surgical; D006801:Humans; D008099:Liver / Q000293:injuries* / Q000601:surgery; D008297:Male; D013536:Suture Techniques; D014949:Wounds, Nonpenetrating / Q000601:surgery