title: Comparison between operative versus non-operative management of traumatic liver injury.
abstract: OBJECTIVE
  The aim of this study was to compare operative versus non-operative management of patients with liver injury and to ascertain the differences of the clinical features.
  
  
  METHODS
  From April 2000 to July 2012, 191 patients were admitted to Seoul St. Mary's Hospital and St. Vincent's Hospital for liver injuries. Of these, 148 patients were included in this study. All patients were diagnosed using computed tomography (CT). The liver injury was graded in accordance with the American Association for the Surgery of Trauma liver injury scoring scale. Patients were divided into two groups: those who underwent surgery and those treated with non-operative management (NOM). There was a comparison between these two groups concerning the clinical characteristics, grade of liver injury, hemodynamic stability, laboratory findings, and mortality.
  
  
  RESULTS
  According to the 148 patient records evaluated, 108 (72.9%) patients were treated with NOM, and 40 (27.1%) underwent surgery. Patients treated with NOM had significantly fewer severe injuries as rated using the Revised Traumatic Injury Scale, Injury Severity Score, and Glasgow Coma Scale. Grade of liver injury and number of patients with extravasation of contrast dye on CT and hemoperitoneum were higher in the operative group than in the NOM group. There were significant differences between the two groups for: heart rate, respiratory rate, systolic blood pressure, and mean hemoglobin levels at admission and after 4 hours. The operative group experienced a significantly higher mortality than the NOM group.
  
  
  CONCLUSIONS
  The results of our study suggest that hemodynamic stability and the following should be considered for deciding the treatment for liver injuries: grade of liver injury, amount of blood loss, and injury scales scores.
authors.affiliation: Department of Surgery, The Catholic University of Korea, St. Vincent's Hospital, Suwon, Korea.
authors.forename: Ki Bum
authors.initials: KB
authors.lastname: Park
authors.affiliation: Department of Surgery, The Catholic University of Korea, St. Vincent's Hospital, Suwon, Korea.
authors.forename: Dong Do
authors.initials: DD
authors.lastname: You
authors.affiliation: Department of Hepato-biliary and Pancreas Surgery, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
authors.forename: Tae Ho
authors.initials: TH
authors.lastname: Hong
authors.affiliation: Department of Surgery, The Catholic University of Korea, St. Vincent's Hospital, Suwon, Korea.
authors.forename: Jung Min
authors.initials: JM
authors.lastname: Heo
authors.affiliation: Department of Surgery, The Catholic University of Korea, St. Vincent's Hospital, Suwon, Korea.
authors.forename: Yong Sung
authors.initials: YS
authors.lastname: Won
keywords: Abdominal injury; Liver; Liver injury; Operation; Trauma