[Current place of thr perihepatic absorbable mesh. Apropos of a series of 105 traumas of the liver].
From October 1987 to June 1993, 105 patients with liver trauma including 71 patients with multiple trauma were admitted to the emergency unit of the Hôpital Sud in Marseilles. Mean age was 32 +/- 15 years, ranging from 16 to 77 years. 77 were male and 28 were female. 83 cases presented with closed trauma, and there were 11 by knife wounds and 11 gun shot injuries. 22 patients, including 10 with multiple trauma, were not operated. Operation was decided immediately in 38 cases for hypovolemia or during the following six hours because of unstable blood pressure after four units of blood transfusion. The absorbable perihepatic mesh was used by 3 surgeons and 3 others used classical procedures (sutures, packing). Global mortality was 15%. The morbidity (31%) was not different from other reports but was significantly lower when using the mesh (p = 0.002). This technique can achieve rapid and lasting hemostasis and bilistasis without any increase of cholestasis or hepatic cytolysis compared to conventional procedures, and without any alteration of laboratory parameters, as shown by specific laboratory tests and follow-up liver biopsies. The mesh also avoids compression of the adjacent organs, compared to packing, thereby avoiding respiratory and renal impairment and reoperation. It can be used in a septic context and in combination with all kinds of radiologic follow-up and percutaneous aspiration and drainage.
Brunet
C
C
Service de Chirurgie générale et urgences, Hôpital Sainte-Marguerite, Marseille.
Sielezneff
I
I
Thomas
P
P
Thirion
X
X
Sastre
B
B
Farisse
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D004635:Emergency Medicine; D005260:Female; D006801:Humans; D008099:Liver / Q000293:injuries* / Q000601:surgery; D008107:Liver Diseases / Q000453:epidemiology / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D013526:Surgical Mesh; D014948:Wounds, Gunshot; D014951:Wounds, Stab
Place actuelle du filet péri-hépatique résorbable. A propos d'une série de 105 traumatismes du foie.