Laparoscopic Surgery for Liver Rupture:a Report of 62 Cases
10.3969/j.issn.1009-6604.2015.04.010
- VernacularTitle:肝破裂腹腔镜手术62例报告
- Author:
Binyong XU
;
Yang JIANG
;
Xingbao FANG
- Publication Type:Journal Article
- Keywords:
Laparoscopy;
Liver rupture
- From:
Chinese Journal of Minimally Invasive Surgery
2015;(4):321-323
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the feasibility and clinical effects of laparoscopic operation for liver rupture . Methods A retrospective analysis was made on 62 cases of traumatic rupture of liver in this hospital from June 2012 to April 2014.The techniques of hemostasis included coagulation , hemostasis gauze packing , rupture suture , hepatic artery ligation , and debridement hepatectomy. Results The laparoscopic operation was successfully completed in 56 cases, with a success rate of 90.3%(56/62). Conversion to open surgery was required in 6 cases due to massive hemorrhage and difficult location of lesions , including 2 cases of grade Ⅲliver rupture , 3 cases of grade Ⅳ, and 1 case of grade Ⅴ.Patients with liver rupture of grade Ⅰ and Ⅱwere all operated without conversions to laparotomy .One patient with grade Ⅲwas complicated with biliary leakage .In patients with grade Ⅳ, one was complicated by biliary leakage and another by obstructive jaundice .In patients with grade Ⅴ, one was complicated by systemic multiple organ dysfunction leading to death and another by biliary tract bleeding who was cured by active symptomatic treatment .The complication rate was 8.1%(5/62).The mortality rate was 1.6%(1/62).All the patients were followed up for three months .All the patients recovered well . Conclusion For grade Ⅰ,Ⅱ, andⅢliver rupture , laparoscopic surgery is safe and feasible .But for grade Ⅳand Ⅴpatients, laparoscopic surgery bears high rates of converting to open operation and postoperative complications , so we suggest open surgery as the first choice .
