Study about Control of Hemorrhage in Liver Trauma | Chapter 11 | Issues and Developments in Medicine and Medical Research Vol. 1

 Background: Controlling haemorrhage after significant liver trauma is still a surgical challenge, since surgeons are regularly confronted with difficult scenarios. Hemorrhage management is first achieved in small liver injuries by packing the bleeding location.

The goal of this study was to examine our experience with bleeding control in significant liver damage.

Materials and Procedures: Our investigation lasted from January 2009 to December 2012 and was conducted prospectively.

There were 173 patients with liver trauma in our study.

Bimanual compression was utilised in 13 patients (15.3%), Pringle procedure in 23 patients (27%), perihepatic packing in 10 patients (11.8%), Foley catheter balloon tamponade in 2 patients (2.4%), and intrahepatic tamponade in 4 patients in the case of an emergent laparotomy (4.7 percent ). Electrocoagulation of the liver injury was used in 12 patients (14.1%), haemostasis and biliostasis followed by hepatic closure 41 patients (48.2%), haemostasis and biliostasis without hepatic closure 6 patients (7.1%), tamponade with a pedicled vascularized omental flap (pedicled omentum hepatorrhaphy) 7 patients (8.2%), anatomic (1.2 percent ).

The surgical procedures used in preplanned laparotomies included left hepatectomy in one patient (16.6%), right hepatectomy in one patient (16.6%), and nonanatomic/atypical liver resections in four patients (66.7 percent ). The severity of the liver injury (z= 5.2912, p=0.00001), other concomitant abdominal organ injuries (z=4.0743, p=0.00005), the volume of blood transfusion received (p=0.03207), and age (p=0.04944) all had a significant impact on treatment success.

The overall mortality rate was 13%.

Conclusion: Perihepatic packing and surgical intervention in two sessions have dramatically increased survival rates in serious liver trauma in our experience.

Author(S) Details

Skënder Buci
Department of Surgery, University Hospital of Trauma, Tirana, Albania.

Dorina Shtjefni
Department of Surgery, University Hospital of Trauma, Tirana, Albania.

Arben Gjata
Department of General Surgery, UHC “Mother Teresa”, Tirana, Albania.

Gjovalin Bushi
Department of Surgery, University Hospital of Trauma, Tirana, Albania.

Sonja (Saraçi) Butorac
Department of Radiology, University Hospital of Trauma, Tirana, Albania.

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