[Surgical strategy for the liver injury and developed abdominal complications]

The authors have analyzed results of treatment of 641 patients with the liver injury: blunt injury--209, penetrating--432. Surgical strategy depends on the condition of the patient on admission, severity of the liver injury and combined trauma. Suturing the rupture (wound) of the liver was the method of choice in the I-II degrees of the liver injury. If it was impossible to achieve hemostasis in the bottom of the wound in the III-IV degrees of the liver injury, package with gauze drain (7) and ligation of the hepatic artery (3) were used. Resection of the liver was performed in 22 patients. In the postoperative period the main complications were: peritonitis (22), subphrenic abscesses (13), hemobilia (7), subhepatic abscesses (6) and liver abscesses (5). Embolization of the hepatic artery branches was preferable in hemobilia. The mortality rate in blunt injuries of the liver was 28.2%, gunshot wounds--27.6% and knife injury--4%.