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Major hepatectomy for complex liver trauma.

Arie Ariche1, Yoram Klein1, Amir Cohen1

  • 11 Department of HPB Surgery, Chaim Sheba Medical Center, Tel Hashomer, Israel ; 2 Trauma Unit, Chaim Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv-Yafo; Israel ; 3 Department of Surgery B, Chaim Sheba Medical Center, Tel Hashomer, Israel.

Hepatobiliary Surgery and Nutrition
|August 28, 2015
PubMed
Summary
This summary is machine-generated.

Hepatic trauma management has evolved from mandatory surgery to selective nonoperative approaches. Specialized centers find surgical treatment, including liver resection, essential for life-saving interventions in severe liver injuries.

Keywords:
Hepatectomyblunt liver traumalaceration of liverliver fixation

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Area of Science:

  • Trauma Surgery
  • Hepatobiliary Surgery
  • Surgical Critical Care

Background:

  • The liver, despite its protected location, is the most frequently injured intraperitoneal organ due to its fragile parenchyma and thin Glisson capsule.
  • Management of hepatic trauma has significantly improved outcomes over decades, shifting from mandatory operations to selective nonoperative strategies.
  • Current approaches include nonoperative management with selective operations, emphasizing packing, damage control, and interventional radiology like angiography and embolization.

Purpose of the Study:

  • To review the evolving management strategies for hepatic trauma.
  • To highlight the role of surgical intervention, including liver resection, in specialized centers.
  • To discuss innovations impacting liver surgery and hepatic resection.

Main Methods:

  • Review of historical and current management paradigms for hepatic trauma.
  • Emphasis on operative techniques such as packing and damage control.
  • Integration of interventional radiology (angiography, embolization) in treatment protocols.

Main Results:

  • Selective nonoperative treatment is now preferred, with operations reserved for specific cases.
  • Liver resection, though associated with high morbidity/mortality, remains a critical life-saving option in specialized centers.
  • Innovations in liver transplantation and specialized surgical teams have advanced hepatic resection techniques.

Conclusions:

  • The management of hepatic trauma has transformed, prioritizing nonoperative approaches with selective surgical intervention.
  • Specialized centers play a crucial role in managing complex hepatic injuries, where surgical treatment, including resection, is often necessary.
  • Advancements in liver surgery continue to improve outcomes for patients with severe hepatic trauma.