Treatment of trauma to right posterior liver using laparoscopic surgery with patients in the left semiprone position: an experience on 18 patients
10.3760/cma.j.cn113884-20201027-00563
- VernacularTitle:左侧卧位腹腔镜手术治疗肝右后叶外伤18例临床分析
- Author:
Libai LU
1
;
Wei WANG
;
Pengyu CHEN
;
Tianwei YAO
;
Zongjiang LUO
;
Wenchuan LI
;
Jian PU
;
Qianli TANG
;
Jianchu WANG
Author Information
1. 右江民族医学院附属医院肝胆外科，广西百色 533000
- Keywords:
Wounds and injuries;
Liver;
Laparoscopy;
Left semiprone position
- From:
Chinese Journal of Hepatobiliary Surgery
2021;27(8):566-569
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the feasibility and safety in treatment of trauma to right posterior liver using laparoscopic surgery with patients in the left semiprone position.Methods:The clinical data of consecutive patients who were diagnosed to have trauma to the right posterior liver and were treated with laparoscopic surgery with patients in the left semiprone position at the Department of Hepatobiliary Surgery, the Affiliated Hospital of Youjiang Medical University for Nationalities between February 2016 and August 2020 were retrospectively analysed. The patients’ gender, age, mechanisms of injury, operative methods, operative time, amounts of abdominal effusion, degrees of liver injury, extents of intraoperative bleeding, amounts of postoperative drainage, lengths of postoperative hospital stay, and major postoperative complications were recorded and analyzed.Results:Among the 18 patients, there were 16 males and 2 females, aged (41.6±14.4) years. The mechanisms of liver trauma were caused by fall injury ( n=10), traffic accidents ( n=4), blunt injury ( n=2) and penetrating injury ( n=2). The levels of injuries were level Ⅲ in 16 patients and level Ⅳ in 2 patients. Laparoscopic suture repair was performed in 8 patients, partial hepatectomy in 4 patients, electrocoagulation hemostasis in 4 patients and ligation of bleeding vessels in 2 patients. All were successful in hemostasis. Abdominal effusion was (1 528.8±373.2) ml, intraoperative blood loss (80.6±16.7) ml, operation time (88.5±9.1) min, postoperative hospital stay 7 days and postoperative total drainage (93.8±13.6) ml. Ten patients were complicated with right pleural effusion, and they recovered with conservative treatment. There were no bile leakage, infection and other complications. Conclusion:Trauma to right posterior liver treated with laparoscopic with surgery patients in the left semiprone position had the advantages of adequate exposure which facilitated surgical hemostasis, resulting in minimal collateral damages and short hospital stay. The treatment was feasibility and safe.
