Outcome of anatomic hepatic resection in patients with severe liver trauma

Background: the liver is the organ most commonly injured during abdominal trauma. The use of anatomic resection for liver trauma is advocated a conservative surgical approach when operative intervention is required

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Objective: to assess the results of anatomic liver resection for severe liver trauma

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Patients and Methods: during the period 2003 to 2005, among 100 patients with abdominal trauma and different types of liver injury admitted at El-Minia University Hospital, 20 patients had severe liver injuries and underwent anatomical hepatic resection. All patients had grade IV injury. Pringle maneuver was applied to control hemorrhage. The resections performed included, bi-segmentectomy of segment 6 and segment 7 [n= 8], left lateral segment resection [n = 6], right lobectomy [n = 4] and segmental resection of segment 6 [n= 2]

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Results: the mortality rate was 5%, as one patient died postoperatively due to major hepatic vein injury, while the morbidity rate was 25%. Postoperatively, there was a statistically significant improvement in hemodynamic status. One month after surgery, there was statistically non significant minimal change in liver functions

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Conclusion: an anatomic resection of the liver for trauma in appropriate situations may be a useful, safe procedure today