CHANGING TECHNIQUES OF SURGERY FOR HEPATIC TRAUMA

Abstract

While most of the hepatic traumas can be treated using simple surgical techniques, patients hemodinamicalty stable can also be treated nonoperatively with the aid of computer tomographic screening. All of the minor hepatic traumas can be treated by just simply suturing the wound edges, but the major traumas require other techniques, such as hepatoraphy, hepatotomy and selective vascular ligation, resectional debridement and perihepatic packing. Anatomic lobar resection is not used frequently today. To provide temporary hemostasis in major hepatic parenchymatous hemorrhages, Pringle maneuver, damping of vena cava inferior-aorta or atriocaval shunts are used till the complete hemotasis is achieved. Mortality of hepatic traumas is about 15-20 percent, and the most important cause of death is hemorrhage. Another complication occuring in the late postoperative period is intra-abdominal sepsis.