To probe into effective surgical procedures and improve the outcome of treatment for patients with severe hepatic injury. Methods: A retrospective study involving 113 patients with seve re hepatic trauma (AAST grade I...To probe into effective surgical procedures and improve the outcome of treatment for patients with severe hepatic injury. Methods: A retrospective study involving 113 patients with seve re hepatic trauma (AAST grade IV and V) during the past 12 years was carried out . Ninety eight patients underwent surgical treatment. Surgical interventions in cluding hepatectomy or direct control of bleeding vessels by finger fracture tec hnique with Pringle maneuver, selective ligation of hepatic artery, retrohepatic caval repair with total hepatic vascular occlusion, and perihepatic packing wer e mainly used. Results: In the 98 patients treated operatively, the survival r ate was 69.4 % (68/98). Among 40 patients with juxtahepatic venous injury (JH VI), 15 were cured with the maximum blood transfusion of 12 000 ml. Eight ca ses of Grade IV injury treated nonoperatively were cured. The percentage of fail ure of nonoperative management was 42.9 % (6/14). The overall mortality rate was 32.7 % (37/113), and 57% of the deaths were due to exsanguination. Conclusions: Reasonable surgical procedures based on classifica tion of hepatic injuries can increase the survival rate of severe liver trauma. Accurate perihepatic packing is effective in dealing with JHVI.展开更多
文摘To probe into effective surgical procedures and improve the outcome of treatment for patients with severe hepatic injury. Methods: A retrospective study involving 113 patients with seve re hepatic trauma (AAST grade IV and V) during the past 12 years was carried out . Ninety eight patients underwent surgical treatment. Surgical interventions in cluding hepatectomy or direct control of bleeding vessels by finger fracture tec hnique with Pringle maneuver, selective ligation of hepatic artery, retrohepatic caval repair with total hepatic vascular occlusion, and perihepatic packing wer e mainly used. Results: In the 98 patients treated operatively, the survival r ate was 69.4 % (68/98). Among 40 patients with juxtahepatic venous injury (JH VI), 15 were cured with the maximum blood transfusion of 12 000 ml. Eight ca ses of Grade IV injury treated nonoperatively were cured. The percentage of fail ure of nonoperative management was 42.9 % (6/14). The overall mortality rate was 32.7 % (37/113), and 57% of the deaths were due to exsanguination. Conclusions: Reasonable surgical procedures based on classifica tion of hepatic injuries can increase the survival rate of severe liver trauma. Accurate perihepatic packing is effective in dealing with JHVI.
