Yıl: 2023 Cilt: 29 Sayı: 1 Sayfa Aralığı: 122 - 129 Metin Dili: İngilizce DOI: 10.14744/tjtes.2021.89678 İndeks Tarihi: 25-07-2023

The role of liver resection in the management of severe blunt liver trauma

Öz:
BACKGROUND: The management of hepatic trauma has a historical progress from mandatory operation with selective non-opera- tive treatment, to non-operative treatment with selective operation. Liver resection (LR) seems to have a minimal role in the manage- ment of liver injury. However, surgical treatment becomes the only life-saving treatment in cases with severe liver trauma. METHODS: It is a retrospective presentation of five cases with severe blunt liver injury whose were admitted at our center during the 8-year period. RESULTS: The median age of patients was 30.8 (23–43). The most frequent mechanism of injury was pedestrian struck (60%). Two of five cases were transferred to our hospital from rural state hospitals after initial attempt to achieving hemostasis. The majority of liver injury was grade V (80%). The right lobe of the liver was injured in different extensions. Major vascular injury was associated to liver in- jury in four of five cases. The right hepatectomy (n=1), resectional debridement of segments 5, 6, and 7 (n=1), posterior sectorectomy (n=2), and segment 7 resection (n=1) were performed for hemostasis. Vascular injuries in the junction of inferior vena cava and right hepatic vein (n=1), the anterior surface of the right hepatic vein (n=1), the junction of segment 7 hepatic vein and right hepatic vein (n=1), the main portal vein (n=1), and the right renal vein (n=1) were repaired. Median operation time was 162 min (120–180 min). Operative mortality was 20%. Reoperation was needed in three of four survived cases. In-hospital complications were observed in two of four survived cases. Median stay in intensive care unit and hospital was 12.4 days (1–48 days) and 28.2 days (1–65 days), respectively. CONCLUSION: When a severe liver injury is unresponsive to packing, the surgeon must always keep in mind that extensive maneu- vers for vascular control and LR are required for bleeding control.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Olgu Sunumu Erişim Türü: Erişime Açık
0
0
0
  • 1. Trunkey DD. Hepatic trauma: Contemporary management. Surg Clin N Am 2004;84:437–50. [CrossRef ]
  • 2. Fang JF, Chen RJ, Lin BC, Hsu YB, Kao JL, Chen MF. Blunt hepat- ic injury: Minimal intervention is the policy of treatment. J Trauma 2000;49:722–8. [CrossRef ]
  • 3. Nicol AJ, Hommes M, Primrose R, Navsaria PH, Krigeet JE. Packing for control of hemorrhage in major liver trauma. World J Surg 2007;31:569– 74. [CrossRef ]
  • 4. Gaarder C, Naess PA, Eken T, Skaga NO, Pillgram-Larsen J, Klow EN, et al. Liver injuries-improved results with a formal protocol including an- giography. Injury 2007;38:1075–83. [CrossRef ]
  • 5. Osler T, Baker SP, Long W. A modification of the injury severity score that both improves accuracy and simplifies scoring. J Trauma 1997;43:922–5.
  • 6. Champion HR, Sacco WJ, Copes WS, Gann DS, Gennarelli TA, Flana- gan ME. A revision of the trauma score. J Trauma 1989;29:623–9.
  • 7. Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II: A severity of disease classification system. Crit Care Med 1985;13:818–29.
  • 8. Moore EE, Cogbill TH, Jurkovich GJ, Shackford SR, Malangoni MA, Champion HR. Organ injury scaling: Spleen and liver (1994 revision). J Trauma 1995;38:323–4. [CrossRef ]
  • 9. McCrum ML, McKee J, Lai M, Staples J, Switzer N, Widder SL. ATLS adherence in the transfer of rural trauma patients to a level I facility. Inju- ry 2013;44:1241–5. [CrossRef ]
  • 10. Tanaka T, Kawashita Y, Kawahara D, Kuba S, Kawahara Y, Fujisawa H, et al. Complete dissection of a hepatic segment after blunt abdominal in- jury successfully treated by anatomical hepatic lobectomy: Report of a case. Case Rep Gastroenterol 2011;5:125–31. [CrossRef ]
  • 11. Schecter PW, Hirshberg A. Injuries to the liver and biliary tract. In: Jar- nagin W editors. Blumgart’s Surgery of the Liver, Biliary Tract and Pan- creas. 6th ed. Netherlands: Elsevier; 2016. p. 1889–97. [CrossRef ]
  • 12. Cogbil TH, Moore EE, Jurkovich GJ, Feliciano DV, Morris JA, Mucha P. Severe hepatic trauma: A multi-center experience with 1,335 liver inju- ries. J Trauma 1988;28:1433–8. [CrossRef ]
  • 13. Birincioglu I, Topaloglu S, Turan N, Cekic AB, Ak H, Cinel A, et al. De- tailed dissection of hepato-caval junction and suprarenal inferior vena cava. Hepatogastroenterology 2011;58:311–7.
  • 14. Buckman RF Jr., Miraliakbari R, Badellinoet MM. Juxtahepatic venous injuries: A critical review of reported management strategies. J Trauma 2000;48:978–84. [CrossRef ]
  • 15. Khaneja SC, Pizzi WF, Barie PS, Ahmed N. Management of penetrating juxtahepatic inferior vena cava injuries under total vascular occlusion. J Am Coll Surg 1997;184:469–74.
  • 16. Baumgartner F, Scudamore C, Nair C, Karusseit O, Hemminget A. Venovenous bypass for major hepatic and caval trauma. J Trauma 1995;39:671–3. [CrossRef ]
  • 17. Schrock T, Blaisdell FW, Mathewson C Jr. Management of blunt trauma to the liver and hepatic veins. Arch Surg 1968;96:698–704. [CrossRef ]
  • 18. Boggi U, Vistoli F, Chiaro MD, Signori S, Sgambelluri F, Roncella M, et al. Extracorporeal repair and liver autotransplantation after total avulsion of hepatic veins and retrohepatic inferior vena cava injury secondary to blunt abdominal trauma. J Trauma 2006;60:405–6. [CrossRef ]
  • 19. Hollands MJ, Little JM. Hepatic venous injury after blunt abdominal trauma. Surgery 1990;107:149–52.
  • 20. Lentschener C, Ozier Y. Anesthesia for elective liver resection: Some points should be revisited. Eur J Anaesthesiol 2002;19:780–8. [CrossRef ]
  • 21. Tympa A, Theodoraki K, Tsaroucha A, Arkadopoulos N, Vassiliou I, Smyrniotis V. Anaesthetic considerations in hepatectomies under hepatic vascular control. HBP Surg 2012;2012:720754. [CrossRef ]
  • 22. Mirski MA, Lele AV, Fitzsimmons L, Toung TJ. Diagnosis and treatment of vascular air embolism. Anesthesiology 2007;106:164–77. [CrossRef ]
  • 23. Strong RW, Lynch SV, Wall DR, Liu CL. Anatomic resection for severe liver trauma. Surgery 1998;123:251–7. [CrossRef ]
  • 24. Oguz S, Yıldırım R, Topaloglu S. Role of percutaneous transhepatic bili- ary drainage in the management of blunt liver trauma: A case report. Ulus Travma Acil Cerrahi Derg 2017;23:441–4. [CrossRef ]
  • 25. Ocak I, Topaloglu S, Acarli K. Posthepatectomy liver failure. Turk J Med Sci 2020;50:1491–503. [CrossRef ]
APA KÜÇÜKASLAN H, Tayar S, oğuz ş, Topaloglu S, geze s, Şenel A, Calik A (2023). The role of liver resection in the management of severe blunt liver trauma. , 122 - 129. 10.14744/tjtes.2021.89678
Chicago KÜÇÜKASLAN HAKAN,Tayar Serkan,oğuz şükrü,Topaloglu Serdar,geze sukran,Şenel Ahmet Can,Calik Adnan The role of liver resection in the management of severe blunt liver trauma. (2023): 122 - 129. 10.14744/tjtes.2021.89678
MLA KÜÇÜKASLAN HAKAN,Tayar Serkan,oğuz şükrü,Topaloglu Serdar,geze sukran,Şenel Ahmet Can,Calik Adnan The role of liver resection in the management of severe blunt liver trauma. , 2023, ss.122 - 129. 10.14744/tjtes.2021.89678
AMA KÜÇÜKASLAN H,Tayar S,oğuz ş,Topaloglu S,geze s,Şenel A,Calik A The role of liver resection in the management of severe blunt liver trauma. . 2023; 122 - 129. 10.14744/tjtes.2021.89678
Vancouver KÜÇÜKASLAN H,Tayar S,oğuz ş,Topaloglu S,geze s,Şenel A,Calik A The role of liver resection in the management of severe blunt liver trauma. . 2023; 122 - 129. 10.14744/tjtes.2021.89678
IEEE KÜÇÜKASLAN H,Tayar S,oğuz ş,Topaloglu S,geze s,Şenel A,Calik A "The role of liver resection in the management of severe blunt liver trauma." , ss.122 - 129, 2023. 10.14744/tjtes.2021.89678
ISNAD KÜÇÜKASLAN, HAKAN vd. "The role of liver resection in the management of severe blunt liver trauma". (2023), 122-129. https://doi.org/10.14744/tjtes.2021.89678
APA KÜÇÜKASLAN H, Tayar S, oğuz ş, Topaloglu S, geze s, Şenel A, Calik A (2023). The role of liver resection in the management of severe blunt liver trauma. Ulusal Travma ve Acil Cerrahi Dergisi, 29(1), 122 - 129. 10.14744/tjtes.2021.89678
Chicago KÜÇÜKASLAN HAKAN,Tayar Serkan,oğuz şükrü,Topaloglu Serdar,geze sukran,Şenel Ahmet Can,Calik Adnan The role of liver resection in the management of severe blunt liver trauma. Ulusal Travma ve Acil Cerrahi Dergisi 29, no.1 (2023): 122 - 129. 10.14744/tjtes.2021.89678
MLA KÜÇÜKASLAN HAKAN,Tayar Serkan,oğuz şükrü,Topaloglu Serdar,geze sukran,Şenel Ahmet Can,Calik Adnan The role of liver resection in the management of severe blunt liver trauma. Ulusal Travma ve Acil Cerrahi Dergisi, vol.29, no.1, 2023, ss.122 - 129. 10.14744/tjtes.2021.89678
AMA KÜÇÜKASLAN H,Tayar S,oğuz ş,Topaloglu S,geze s,Şenel A,Calik A The role of liver resection in the management of severe blunt liver trauma. Ulusal Travma ve Acil Cerrahi Dergisi. 2023; 29(1): 122 - 129. 10.14744/tjtes.2021.89678
Vancouver KÜÇÜKASLAN H,Tayar S,oğuz ş,Topaloglu S,geze s,Şenel A,Calik A The role of liver resection in the management of severe blunt liver trauma. Ulusal Travma ve Acil Cerrahi Dergisi. 2023; 29(1): 122 - 129. 10.14744/tjtes.2021.89678
IEEE KÜÇÜKASLAN H,Tayar S,oğuz ş,Topaloglu S,geze s,Şenel A,Calik A "The role of liver resection in the management of severe blunt liver trauma." Ulusal Travma ve Acil Cerrahi Dergisi, 29, ss.122 - 129, 2023. 10.14744/tjtes.2021.89678
ISNAD KÜÇÜKASLAN, HAKAN vd. "The role of liver resection in the management of severe blunt liver trauma". Ulusal Travma ve Acil Cerrahi Dergisi 29/1 (2023), 122-129. https://doi.org/10.14744/tjtes.2021.89678