[Management of hepatic trauma in 267 cases]

Two hundred and sixty-seven consecutive hepatic trauma in recent 17 years were analysed. They were classified by AAST classification: grade I and II 68 cases (25.4%), grade III 132 cases (49.44%), grade IV 52 cases (19.48%) and grade V 15 cases (5.6%) and 237 cases were operated in different procedures according to the severity of the trauma. More than ten modalities such as dedridement, suturing, repairment, abdominal drainage, billiary drainage, hepatic artery ligation, packing and pressing hemostasis, resection of traumatic parecchyma, vessel ligation with suturing in section etc were used, The morbidity and mortality were 20.6% and 8.9%, respectively. The other 24 cases were found no active bleeding during laporatomy and rehabitated with preservative management. The authors believe that effective management on time and intensive perioperative care are important to minimize the morbidity and mortality of hepatic trauma. Nonoperative management deserves enough attention.