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Management of liver trauma
S A Badger1, R Barclay, P Campbell
1Hepatobiliary Surgical Unit, Mater Hospital, Crumlin Road, Belfast, BT14 6AB Northern Ireland, UK. Stephen@Badger.tc
World Journal of Surgery
|September 18, 2009
Summary
Liver trauma management has evolved, favoring nonoperative approaches for stable patients. Advanced imaging like CT and interventional radiology are key, with damage control surgery for severe cases.
Area of Science:
- Trauma Surgery
- Surgical Management
- Abdominal Trauma
Background:
- Liver trauma is a frequent and challenging clinical problem.
- Blunt and penetrating injuries necessitate complex diagnostic and management strategies.
Purpose of the Study:
- To review current consensus on liver trauma investigation and management.
- To outline evolving strategies for optimal patient outcomes.
Main Methods:
- Comprehensive literature review.
- Analysis of current diagnostic and therapeutic guidelines for liver trauma.
Main Results:
- Computerised tomography (CT) is the gold standard for liver injury diagnosis.
- Nonoperative management is preferred for stable patients; laparotomy for unstable.
- Damage control techniques (packing, hepatotomy) are recommended; complex procedures are often redundant.
- Interventional radiology plays an increasing role.
Conclusions:
- Liver injury management has significantly advanced, reducing the need for operative intervention in many cases.
- Transfer to specialist centers is crucial for complex injuries and complications to ensure optimal outcomes.
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