title: Major hepatectomy for complex liver trauma.
abstract: The liver is the most frequently injured intraperitoneal organ, despite its relatively protected location. The liver consisting of a relatively fragile parenchyma contained within the Glisson capsule, which is thin and does not provide it with great protection. The management of hepatic trauma has undergone a paradigm shift over the past several decades with significant improvement in outcomes. Shifting from mandatory operation to selective nonoperative treatment, and, presently, to nonoperative treatment with selective operation. Operative management emphasizes packing, damage control, and utilization of interventional radiology, such as angiography and embolization. Because of the high morbidity and mortality, liver resection seems to have a minimal role in the management of hepatic injury in many reports, but in a specialized referral center, like our institute, surgical treatment becomes, in many cases, the only life-saving treatment. Innovations in liver transplant surgery, living liver donation, and the growth of specialized liver surgery teams have changed the way that surgeons and hepatic resection are done.
authors: 1 Department of HPB Surgery, Chaim Sheba Medical Center, Tel Hashomer, Israel ; 2 Trauma Unit, Chaim Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv-Yafo; Israel ; 3 Department of Surgery B, Chaim Sheba Medical Center, Tel Hashomer, Israel.
authors: Arie
authors: A
authors: Ariche
authors: 1 Department of HPB Surgery, Chaim Sheba Medical Center, Tel Hashomer, Israel ; 2 Trauma Unit, Chaim Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv-Yafo; Israel ; 3 Department of Surgery B, Chaim Sheba Medical Center, Tel Hashomer, Israel.
authors: Yoram
authors: Y
authors: Klein
authors: 1 Department of HPB Surgery, Chaim Sheba Medical Center, Tel Hashomer, Israel ; 2 Trauma Unit, Chaim Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv-Yafo; Israel ; 3 Department of Surgery B, Chaim Sheba Medical Center, Tel Hashomer, Israel.
authors: Amir
authors: A
authors: Cohen
authors: 1 Department of HPB Surgery, Chaim Sheba Medical Center, Tel Hashomer, Israel ; 2 Trauma Unit, Chaim Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv-Yafo; Israel ; 3 Department of Surgery B, Chaim Sheba Medical Center, Tel Hashomer, Israel.
authors: Eylon
authors: E
authors: Lahat
keywords: Hepatectomy; blunt liver trauma; laceration of liver; liver fixation