TY  - JOUR
TI  - The role of liver resection in the management of severe blunt liver trauma
AB  - 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.
AU  - KÜÇÜKASLAN, HAKAN
AU  - Tayar, Serkan
AU  - oğuz, şükrü
AU  - Topaloglu, Serdar
AU  - Şenel, Ahmet Can
AU  - Calik, Adnan
AU  - geze, sukran
DO  - 10.14744/tjtes.2021.89678
PY  - 2023
JO  - Ulusal Travma ve Acil Cerrahi Dergisi
VL  - 29
IS  - 1
SN  - 1306-696X
SP  - 122
EP  - 129
DB  - TRDizin
UR  - http://search/yayin/detay/1189450
ER  -