Management strategy of non-penetrating hepatic trauma / 解放军医学杂志

ABSTRACT

Objective To explore the current status of non-operative management strategy for blunt hepatic trauma. Methods The clinical data of patients with blunt hepatic trauma admitted to our hospital during the past 15 years were retrospectively analyzed, and the new standpoints in the selection of therapeutic strategy for blunt hepatic trauma were elucidated with referance to recent litereture, especially regarding the different opinions in non-operative management in the treatment of blunt hepatic trauma between the developed countries and China. Results The concept in the selection of therapeutic strategy for blunt hepatic trauma in China lagged relatively behind the advanced countries. Compared with that in the developed countries, the percentage of non-operative management was significantly lower in China (10%-30% vs 50%-80%), and the fewer CT scanning was carried out in the patients with stable hemodynamics. Conclusion Non-operative management is becoming one of the most important strategies in the treatment of blunt hepatic trauma nowadays. Non-operative management is widely acknowledged as the first choice for blunt hepatic trauma, especially for those with stable hemodynamics. This new trend should be more emphasized in China. Besides, CT scanning as a diagnostic tool should be carried out as frequently as possible in those patients with stable hemodynamics.