Management of liver trauma.

Abstract

BACKGROUND AND METHODS:

Management of blunt or penetrating injuries to the liver remains a significant challenge. This review discusses the mechanisms of liver injury, grading system for severity, available diagnostic modalities and current management options. It is based on a Medline literature search and the authors' clinical experience.

RESULTS:

Unstable patients require immediate laparotomy, but selected patients who are haemo- dynamically stable may be managed without operation. The preferred operative techniques include resectional debridement, hepatotomy with direct suture ligation and perihepatic packing; anatomical resection, hepatic artery ligation and various bypass techniques have a limited, more defined role for selected injuries. Major complications include haemorrhage, sepsis and bile leak.

CONCLUSION:

Enhanced resuscitation, anaesthesia and intensive care have contributed to a significant reduction in mortality rates from liver trauma. Optimum results are obtained with a specialist team that includes an experienced liver surgeon, anaesthetist, endoscopist and interventional hepatobiliary radiologist with expertise in managing postoperative complications.

• Authors: R W Parks, E Chrysos, T Diamond
• Journal: The British journal of surgery (Br J Surg) Vol. 86 Issue 9 Pg. 1121-35 (Sep 1999) ISSN: 0007-1323 [Print] England
• PMID: 10504364 (Publication Type: Journal Article, Review)

Topics

• Humans
• Injury Severity Score
• Liver (injuries)
• Postoperative Complications (etiology)
• Surgical Mesh
• Tomography, X-Ray Computed
• Wounds, Nonpenetrating (diagnosis, surgery, therapy)
• Wounds, Penetrating (diagnosis, surgery, therapy)