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Laparoscopic Anatomical Liver Segment VII Resection with Liver Parenchymal Transection Following a Priority Approach

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Published on: May 23, 2025

Evolution in liver trauma management: a single centre experience.

Paulien Bonny^1,2, Constantijn Bogaert^1,2, Luís Filipe Abreu de Carvalho²

¹Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.

Acta Chirurgica Belgica

|April 12, 2024

Summary

This summary is machine-generated.

Non-operative management is preferred for liver trauma, but surgery is indicated for hemodynamically unstable patients, high-grade injuries, penetrating trauma, and associated lesions. Conservative therapy or embolization effectively manages other liver trauma cases.

Keywords:

Liver injury angioembolisation non-operative management surgery trauma

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Area of Science:

Trauma Surgery
Surgical Management
Emergency Medicine

Background:

Liver trauma is a common surgical emergency.
Management options include non-operative management (NOM), radiological embolization, and surgery.
Criteria for selecting the optimal treatment strategy for liver trauma remain incompletely defined.

Purpose of the Study:

To assess the evolution and outcomes of liver injury management over a 20-year period.
To evaluate the changing role of surgery versus NOM in liver trauma.
To identify specific criteria guiding surgical intervention for liver trauma.

Main Methods:

Retrospective analysis of 406 liver trauma cases at a level I trauma center (January 1996 - June 2020).
Evaluation of injury type, grade, hemodynamic stability, transfer status, and treatment modalities.
Assessment of outcomes including mortality, hospitalisation duration, and intensive care unit stay.

Main Results:

Blunt trauma (92.4%) was more common than penetrating trauma (7.6%).
Non-operative management was initiated in 72.9% of patients.
Surgery was predominantly used for penetrating trauma (74.2%) and hemodynamically unstable patients.

Conclusions:

The role of surgery in liver trauma has decreased, with NOM being preferred.
Hemodynamic instability, high-grade lesions, penetrating injuries, and severe associated injuries are key indications for surgery.
NOM, including conservative treatment and radiological embolization, is effective for managing less severe liver trauma.