The Surgical Management of Liver Trauma

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Abstract
During the past three years, 126 patients with liver trauma have been treated at Harbor General Hospital, 49 having blunt injuries and 77 having penetrating liver wounds. Fourteen patients required emergency hepatic resections, 45 had choledochostomy plus drainage, and 67 had perihepatic drainage alone. Significant orthopedic, thoracic, neurological, or other intra-abdominal injuries occurred in 55 patients. The mortality total was eight of 126 patients, 6.3%. The presence of associated injuries was the greatest factor adversely affecting survival, seven of the eight deaths being multiple trauma victims. Major complications requiring secondary operations occurred in 11 patients. The morbidity and mortality arising from penetrating and blunt trauma to the liver is due in part to other associated injuries but also to failure to establish adequate drainage, and reluctance to undertake emergency hepatic resections for massive liver injury.

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