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.
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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)
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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)
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