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[Atriocaval shunt. Report of two cases]
Sebastián Soto1, Roberto Oettinger
1Instituto de Cirugía, Facultad de Medicina, Universidad Austral de Chile, Chile. seba_soto_g@yahoo.es
Revista Medica De Chile
|May 10, 2005
Summary
Severe liver trauma carries high mortality. The atriocaval shunt technique enables bloodless repair of major liver vessels, improving outcomes in complex trauma cases.
Area of Science:
- Trauma Surgery
- Hepatobiliary Surgery
- Vascular Surgery
Background:
- High-grade liver trauma (grades V and VI) is associated with significant mortality rates, ranging from 30% to 70%.
- Surgical management of severe liver injuries presents challenges due to extensive bleeding and complex vascular anatomy.
Observation:
- The atriocaval shunt, first described by Shrock et al. in 1968, provides a method to isolate the retrohepatic vena cava and suprahepatic veins.
- This technique creates a bloodless surgical field, facilitating complex repairs in cases of severe liver trauma.
Findings:
- Two male patients, aged 17 and 18, with severe liver trauma (one blunt, one penetrating shotgun injury) were successfully treated.
- The atriocaval shunt procedure was employed, allowing for successful repair of the injured hepatic vasculature.
Implications:
- Successful application of the atriocaval shunt in these cases suggests its efficacy in managing severe liver trauma.
- This technique, when performed by experienced surgeons, can achieve survival rates comparable to other established methods for managing high-grade liver injuries.