Uncontrolled
hemorrhage is the primary cause of death in both blunt and penetrating liver
trauma. Cryohemostasis was attempted in the past for elective liver surgery but did not gain popularity. During past decades, cryoequipment was refined and successfully used for
tumor ablation. The purpose of the present study was to assess the efficacy of
cryosurgery as a potential adjuvant
hemostatic technique in the treatment of grades III-IV liver
injuries. A standard liver crush-evulsion injury was created in pigs. In the control group, the liver was left to bleed freely. In the experimental group, the severed liver surface was immediately frozen to -160 degrees C for 10 min, spontaneously thawed, and left to bleed thereafter. Blood pressure, pulse rate, urine output, and serum
lactate were monitored. The total blood loss was measured 180 min after liver injury was inflicted. The volume of frozen liver parenchyma was measured. For further laboratory evaluation, three additional experimental animals were not sacrificed and recovered. Cryohemostasis significantly reduced blood loss and substantially attenuated
hemorrhagic shock. The frozen liver parenchyma underwent
necrosis but did not jeopardize survival.
Cryosurgery may be an efficient adjuvant technique in the early control of
hemorrhage in grades III-IV liver injury.