Acta Chir Orthop Traumatol Cech. 1998; 65(6):365-369
[Topical issue of the injury of liver.].
- Chirurgické oddelenie NsP Ruzinov, Bratislava.
The authors analyse their own 10-year clinical material (1 August 1987-31 July 1997). In the course of this period they operated on 40 patients for the injury of liver. The indications were persisting intra-abdominal bleeding, multiple injuries of organs in the abdominal cavity, simultaneous injuries of diaphragm and gunshot wounds of abdomen. Injuries were classsified according to AAST, the range of organ injury - liver. The treatment of liver was determined by the extent of the injury. In their surgical strategy the authors prefer suture of hepar by collagenous stripes (Parenchymaset, Braun) with sufficient drainage, but they also used resection or packing in dilaceration injuries. Patients with injuries of hepatic veins and retrohepatic inferior vena cava died in the course of resuscitation surgery despite the introduction of en-docaval shunt. The authors accept selective non-surgical treatment of hemodynamically stabilised patients which has been developed thanks to modern visualisation methods. However, such treatment implies a risk of delayed management of significant associated injuries. The fate of patienst is also limited by the extent and seriousness of associated injuries. Key words: liver injury, surgical and non-surgical treatment.
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