Hepatic injuries: management and outcome

Area of Science:

• Trauma Surgery
• Hepatobiliary Surgery
• Surgical Outcomes

Background:

• Liver injuries present a significant challenge in trauma care.
• Understanding injury mechanisms and associated injuries is crucial for effective management.
• Varied injury grades necessitate diverse treatment strategies.

Purpose of the Study:

• To analyze the characteristics of liver injuries treated over a one-year period.
• To compare outcomes between penetrating and blunt liver trauma.
• To evaluate the efficacy of different surgical interventions for liver injuries.

Main Methods:

• Retrospective analysis of 52 patients with liver injuries.
• Categorization of injuries into penetrating and blunt trauma.
• Documentation of associated injuries, injury grades, surgical procedures, and patient outcomes.

Main Results:

• Penetrating trauma (32 patients) was more frequent than blunt trauma (20 patients).
• Penetrating trauma had a higher incidence of associated intra-abdominal injuries.
• Severe liver injuries were common in blunt and gunshot victims (55%, 83.3%), while stab wounds caused simpler injuries (86.7%).
• Suture hepatorrhaphy (57.7%) was the most common procedure, followed by vessel ligation (15.4%), packing (7.7%), and resection (3.8%).
• Overall morbidity was 40.4%, with liver-related complications at 17.3%.
• Total mortality was 13.5%, and liver-related mortality was 9.6%.

Conclusions:

• Liver injuries require prompt and tailored surgical management.
• Penetrating trauma presents unique challenges due to associated intra-abdominal injuries.
• Suture hepatorrhaphy remains a cornerstone in managing liver trauma, with other techniques reserved for specific injury patterns.