Management of 1000 consecutive cases of hepatic trauma (1979-1984)

Ann Surg. 1986 Oct;204(4):438-45. doi: 10.1097/00000658-198610000-00012.

Abstract

From 1979 to 1984, 1000 patients with hepatic injuries were treated at one urban trauma center. Penetrating wounds were present in 86.4% of patients. Simple hepatorrhaphy, use of topical hemostatic agents, or drainage alone were the only forms of therapy required in 881 patients, and 65 (7.3%) died. Extensive hepatorrhaphy or hepatotomy with selective vascular ligation, resectional debridement or resection, selective hepatic artery ligation, or perihepatic packing were required, often in combination, in 119 patients, and 40 (33.6%) died. Uncomplicated recoveries occurred in 798 of the 918 patients (86.9%) surviving greater than 48 hours. In the remaining 13.1% of patients, intra-abdominal abscess formation was the most common late complication (32/918 = 3.5%). Mortality for the entire series of 1000 patients was 10.5%, with 78.1% (82/105) of all deaths occurring in the perioperative period from shock or transfusion-related coagulopathies.

MeSH terms

  • Constriction
  • Drainage
  • Emergencies
  • Hemostasis, Surgical
  • Hepatectomy
  • Humans
  • Liver / injuries*
  • Postoperative Complications / etiology
  • Postoperative Complications / mortality
  • Wounds, Penetrating / therapy*