Document Detail


Anatomic resection for severe liver trauma.
MedLine Citation:
PMID:  9526515     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Most publications during the past decade have condemned the use of anatomic resection for liver trauma and advocated a conservative surgical approach when operative intervention was required. This policy has been supported by the high mortality rate reported by most authorities. The purpose of this study was to assess the results of anatomic hepatic resection for liver trauma in an institution in which the hepatobiliary surgeons are responsible for the management of severe liver injuries. METHODS: During the period 1983 to 1996, 287 patients with liver injuries were admitted to the hospital and 37 patients with severe liver trauma underwent anatomic resection. Demographic, clinical, operative, and postoperative data were collected and analyzed. The resections performed included right hemihepatectomy (n = 27), left hemihepatectomy (n = 1), left lateral segment resection (n = 5), and segmental resection (n = 4). RESULTS: There were three postoperative deaths after right hemihepatectomy (11.1%) and an overall mortality rate of 8.1%. There were no intraoperative deaths. Postoperative complications occurred in 22 patients (60%) and were most frequent in patients with concomitant injuries to other systems. Liver-related morbidity occurred in seven patients (19%). The median postoperative stay was 20 days. CONCLUSIONS: Anatomic hepatic resection for trauma is associated with low mortality and liver-related morbidity rates when performed by experienced hepatobiliary surgeons, and its role in the management of severe hepatic trauma should be reevaluated.
Authors:
R W Strong; S V Lynch; D R Wall; C L Liu
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Surgery     Volume:  123     ISSN:  0039-6060     ISO Abbreviation:  Surgery     Publication Date:  1998 Mar 
Date Detail:
Created Date:  1998-04-14     Completed Date:  1998-04-14     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  251-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, Princess Alexandra Hospital, Brisbane, Australia.
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MeSH Terms
Descriptor/Qualifier:
Female
Hemorrhage / therapy
Hepatectomy / adverse effects,  methods*
Humans
Liver / injuries*,  surgery*
Male
Postoperative Complications

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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