Liver injuries

Abstract

AbstractIn Yugoslavia, liver injuries are still the most frequent indications for liver surgery. From 1975 through 1979, a total of 75 patients with liver injuries were treated operatively; 69 (92%) were caused by blunt and 6 (8%) by sharp trauma.In minor liver ruptures, we removed the devitalized liver tissue by means of the finger‐fracture technique with ligation of blood and bile vessels. After removing the devitalized area, we left the liver widely open and drained with Penrose drains. In major or deep liver ruptures, we performed resection of the affected liver lobes or segment. We always drained the common bile duct with a T‐tube to obtain postoperative information on either patency or leakage from the biliary tree. This procedure has always been free from complications.We performed a resection in 21 patients (28%); of these 4 had a segmentectomy; 3, an atypical resection; and 14, a formal resection. The ages of the patients ranged from 5 to 71 years. After resection, 3 patients died.Seven patients had trauma restricted to the liver, 16 sustained injury to the liver and spleen, and 52 presented with trauma involving the liver and two or more other organs. Injury was further complicated by liver abscess in 7 patients (9.3%), hemobilia in 9 patients (12%), and bile leakage in 2 patients (2.6%). Eight patients (10.6%) required repeated surgery for bleeding and 3 (4%) developed hepatic coma. Forty‐six patients (61.3%) were free of any complications. Mortality was 24%, 18 of 75 patients treated.