Analysis of operation procedures for severe liver injury
10.3760/cma.j.issn.1007-631X.2016.08.015
- VernacularTitle:严重肝损伤的手术方式分析
- Author:
Yiping HONG
- Publication Type:Journal Article
- Keywords:
Wounds and injuries;
Liver;
Hepatectomy
- From:
Chinese Journal of General Surgery
2016;31(8):662-665
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate surgical treatment of severe liver injury.Methods Retrospective analysis on 52 patients with severe liver injury from October 2002 to April 2015 was made in accordance with liver damage by the American Institute of Traumatic Surgery (AAST),incorporated with imaging examinations and intraoperative findings.There were 19 cases of grade Ⅲ,27 of grade Ⅳ,6 cases of grade V.All patients were treated by surgery:simple suture in 4 cases,omentum tamponade in 16 cases,debridement hepatectomy was performed on 24 cases,hepatic segment resection in 2 cases,right liver resection in 1 case,peripheral hepatic gauze packing in 5 cases.Results 48 cases were cured,4 cases died.The cure rate was 92.3％ (48/52),mortality was 7.7％ (4/52),with one dying of right portal vein rupture and bleeding,3 of multiple organ failure.28 patients had one or more complications including postoperative hemorrhage in 3 cases,bile leakage in 6 cases,liver abscess in 5 cases,pleural effusion in 6,incision infection in 3 cases,and deep vein thrombosis of lower limbs in 2.Conclusions CT examination can identify type and degree of liver injury.Level Ⅰ-Ⅱ liver injury are recommended to nonoperative treatment,while level Ⅲ-V liver injury especially with hemodynamic instability or combined with other internal organs injury should be managed surgically.
