Abstract | BACKGROUND/PURPOSE: Liver trauma, especially that as result of road traffic accidents, still remains a complicated problem in severely injured patients. The aim of this study was to extract useful conclusions from the management in order to improve the final outcome of such patients. METHODS: Details for 86 patients with blunt hepatic trauma who were examined and treated in our department during a 6-year period were analyzed. We retrospectively reviewed the severity of liver injury, associated injuries, treatment, and outcome. RESULTS: Forty-nine liver injuries (57%) were of low severity (grades I and II), while 37 (43%) were of high severity (grades III, IV, and V). Liver trauma with associated injury of other organs was noted in 62 (72.1%) patients. Forty-three (50%) patients underwent an exploratory laparotomy within the first 24 h of admission. Thirty-five (71.4%) of the 49 patients with low-grade hepatic injuries were managed conservatively; no mortality occurred. Six (14%) of forty-three patients with liver trauma initially considered for conservative management required surgery due to hemodynamic instability. Five (13.5%) of 37 patients who were finally managed nonoperatively required adjunctive treatment for biloma, hematoma, or biliary leakage; no mortality occurred. The overall mortality rate was 9.3%; mortality rates of 5.8% and 3.5% were due to liver injuries and concomitant injuries, respectively. CONCLUSIONS: Severe hepatic injuries require surgical intervention due to hemodynamic instability. Low-grade injuries can be managed nonoperatively with excellent results, while patients with hepatic trauma with associated organ injuries require surgery, because they continue to have significantly higher mortality.
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Authors | Stavros Gourgiotis, Vasilis Vougas, Stylianos Germanos, Nikitas Dimopoulos, Ioannis Bolanis, Spyros Drakopoulos, Panagiotis Alfaras, Sotiris Baratsis |
Journal | Journal of hepato-biliary-pancreatic surgery
(J Hepatobiliary Pancreat Surg)
Vol. 14
Issue 4
Pg. 387-91
( 2007)
ISSN: 0944-1166 [Print] Japan |
PMID | 17653638
(Publication Type: Journal Article)
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Topics |
- Adult
- Female
- Humans
- Length of Stay
- Liver
(injuries, surgery)
- Liver Diseases
(diagnosis, etiology, therapy)
- Male
- Middle Aged
- Multiple Trauma
(mortality, therapy)
- Retrospective Studies
- Survival Rate
- Treatment Outcome
- Wounds, Nonpenetrating
(mortality, therapy)
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