[Surgical management of serious hepatic injuries].
OBJECTIVE
To explore an effective method of treating serious hepatic injuries.


METHODS
A retrospective analysis was conducted on 92 consecutive cases of serious hepatic injuries during recent 21 years.


RESULTS
Eighty-four cases were treated with operation, and 8 cases with nonoperation management (NOM). Of these patients, 77 (83.5%) were healed, and 15 (16.5%) died. There were complications in 30 patients (31.5%). Hospital stay was 22.3 days.


CONCLUSIONS
Ultrasonography is a valuable diagnostic measure for hepatic injuries. When hemodynamic was stable, CT scanning was especially necessary for patients with complex injuries. Hemostasis is a key measure during operation. Debridement of nonviable hepatic parenchyma is effective management for the decrease of operative complications. If hypotension cannot be corrected actively, clamping of the upper abdominal aorta is an effective measure for patients with hepatic injuries. Serious hepatic injuries can be treated with NOM selectively.
Li
Yi-xiong
YX
Department of General Surgery, Xiangya Hospital, Central South University, Changsha 410078, China.
Lü
Xin-sheng
XS
Lao
Xue-jun
XJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003646:Debridement; D005260:Female; D006488:Hemostasis, Surgical / Q000379:methods; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D055370:Lung Injury; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000000981:diagnostic imaging / Q000601:surgery; D012189:Retrospective Studies; D014463:Ultrasonography