LIVER RESECTIONS FOLLOWING LIVER TRAUMA: A CASE SERIES dristhiyak@gmail.com

 

LIVER RESECTIONS FOLLOWING LIVER TRAUMA: A CASE SERIES

2

Sri Lanka

Poster Exhibition only

Trauma surgeons face significant challenges when dealing with complex hepatic injuries. The surgical management focuses mostly on damage control, packing, and vascular embolisation. In a minority of cases, however, liver resection remains an option, and we provide the outcomes of patients who underwent liver resection following complex hepatic injuries.

From March 2017 to March 2023, data on patients who underwent post-traumatic liver resection by a single surgeon were collected retrospectively. Basic demographics, surgical procedures, and the outcomes were analysed. To classify liver damage, the AAST Hepatic Injury Scale was used. Patients who were lost to follow up and had incomplete records were excluded.

Six patients who underwent liver resection after trauma were included. All were males. Median age was 28.5 years (7-87). 4 (66.7%) were following road traffic accidents and two (33.3%) were after a fall from a height. three (50%) had grade 5 liver injury and two (33.3%) had grade 3 and one (16.7%) had grade 4 liver injury. four (66.7%) underwent primary resection (2 right hepatectomies and 2 segmental resection), two (33.3%) underwent staged resection after selective portal vein and hepatic artery branch ligation to control the bleeding. At a median followup of 32.9 months, two (33.3%) patients died as a result of injuries in the early post-operative period (both these patients underwent primary major liver resection).

Staged major liver resections after selective vascular ligation to control bleeding in unstable patients result in better outcome when compared to primary resection.