[Surgical tactics in closed injuries of the liver]

The results of treatment of 116 patients with closed liver injuries are available. 6 types of liver injuries have been determined, depending on location, rupture and safety of certain intraliver structures. To evaluate the rate of seriousness of a liver injury and decrease the rate of blood loss methods of a temporary haemostasis were used; after that the location and depth of the ruptures were estimated; safety of the vessels, bile tracts and liver parenchyma was evaluated. Nonviable parts of the parenchyma were resected. Various methods of haemostasis were used: ligating, laser and plasma coagulation, use of synthetic films. The external liver compression with an elastic splint was used in case of ineffectiveness of the methods mentioned above. The ligating of the hepatic artery should be used in case of the afferent liver vessels injury.