OPERATIVE CHOLANGIOGRAPHY AND SPECIAL TECHNICAL CONSIDERATION IN MANAGEMENT OF SEVERE INJURY OF LIVER

  • 1 January 1976
    • journal article
    • research article
    • Vol. 143  (5) , 741-748
Abstract
The majority of hepatic injuries in patients can be adequately managed by control of bleeding locally at the site, debridement and ample drainage. In some instances, severe blunt trauma and high velocity missile wounds may result in the disruption of intrahepatic structures and significant devitalization of the parenchyma of the liver, necessitating hepatic resection. Operative cholangiography was useful in the evaluation and management of this type of severe injury to the liver. It is a simple, practical method to recognize and localize a major disruption of the parenchyma of the liver and bile ducts; to help decide whether or not segmental, sublobar or lobar hepatectomy should be performed, and to detect bile leaks from the divided bile ducts after resection of the liver. A modified technique for performing hepatic resection during an emergency situation is probably more suitable than the classic technique. This is based on finger dissection along the line of injury and individual ligation of bile ducts and vessels as they are exposed within the parenchyma of the liver instead of isolation and ligation of the main inflow vessels and of the major ducts at the hilus and retrohepatic ligation of the hepatic veins.

This publication has 1 reference indexed in Scilit: