[Complex surgical therapy for severe hepatic trauma].
OBJECTIVE
To improve the result of surgical therapy for patients with severe hepatic injury.


METHODS
Retrospective analysis was made on the result of surgical treatment of 237 patients with hepatic trauma during the past 8 years. 180 patients underwent surgery. Procedures such as packing with the omentum for the laceration of hepatic parenchyma, debridement or irregular hepatectomy under the direct control of lacerated hepatic blood vessels or Pringle's maneuvre and selective ligation of hepatic artery were used for patients with severe hepatic injury (Grad III-V).


RESULTS
Among the 180 patients, 154 were cured, and 8 of 23 with posthepatic IVC injury were cured with the maximum blood transfusion of 12,000 ml. The overall morality rate was 11.8%(28 of 237 patients). Besides associated injuries inside and outside the abdomen, exsanguination with or without coagulopathy was the main cause of death.


CONCLUSIONS
Accurate liver packing with appropriate adjunctive procedures is effective in the treatment of retrohepatic venous injury.
Gao
J
J
Department of Traumatology, Chongqing Emergency Medical Center, Chongqing 400014.
Tian
X
X
Bai
W
W
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D004211:Disseminated Intravascular Coagulation / Q000601:surgery; D005260:Female; D006801:Humans; D008099:Liver / Q000293:injuries* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012774:Shock, Traumatic / Q000601:surgery*; D013514:Surgical Procedures, Operative / Q000379:methods; D014949:Wounds, Nonpenetrating / Q000601:surgery; D014950:Wounds, Penetrating / Q000601:surgery