[Major liver injury. Role of preoperative transcutaneous endoluminal aortic clamping]

Area of Science:

• Trauma surgery
• Vascular surgery
• Hepatobiliary surgery

Context:

• Severe liver contusions (Type V) present significant management challenges.
• Exsanguination poses a risk of cardiac arrest during surgical intervention.
• Limited effective strategies exist for managing major liver trauma.

Purpose:

• To evaluate the efficacy of percutaneous intra-aortic balloon occlusion combined with surgical hepatic vascular exclusion for severe liver injuries.
• To assess the impact of this combined approach on intra-operative mortality and patient survival.

Summary:

• Three patients with severe liver contusions underwent treatment using percutaneous intra-aortic balloon occlusion and surgical hepatic vascular exclusion.
• Aortic occlusion was achieved via a femoral catheter, followed by surgical vascular exclusion of the liver after hemodynamic stabilization.
• Two of the three patients survived the procedure, with one mortality attributed to associated lung trauma.

Impact:

• Percutaneous intra-aortic balloon occlusion offers a minimally invasive method to control hemorrhage in major liver trauma.
• This technique facilitates safer surgical conditions for liver resection in critically injured patients.
• The combined approach shows potential to improve survival outcomes for severe liver contusions by reducing intra-operative deaths.