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Updated: Jul 20, 2025
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Published on: December 4, 2023
Delayed versus early hepatic resection among patients with severe traumatic liver injuries undergoing damage control
Hamidreza Hosseinpour1, Adam Nelson1, Sai Krishna Bhogadi1
1Division of Trauma, Critical Care, Burns, and Emergency Surgery, Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ, USA.
Introduction:
We aimed to assess the effect of time to hepatic resection on the outcomes of patients with high-grade liver injuries who underwent damage control laparotomy (DCL).
Methods:
This is a 4-year (2017-2020) analysis of the ACS-TQIP. Adult trauma patients with severe liver injuries (AAST-OIS grade ≥ III) who underwent DCL and hepatic resection were included. We excluded patients with early mortality (<24 h). Patients were stratified into those who received hepatic resection within the initial operation (Early) and take-back operation (Delayed).
Results:
Of 914 patients identified, 29% had a delayed hepatic resection. On multivariable regression analyses, although delayed resection was not associated with mortality (aOR:1.060,95%CI[0.57-1.97],p = 0.854), it was associated with higher complications (aOR:1.842,95%CI[1.38-2.46],p < 0.001), and longer hospital (β: +0.129, 95%CI[0.04-0.22],p = 0.005) and ICU (β:+0.198,95%CI[0.14-0.25],p < 0.001) LOS, compared to the early resection.
Conclusion:
Delayed hepatic resection was associated with higher adjusted odds of major complications and longer hospital and ICU LOS, however, no difference in mortality, compared to early resection.
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