38 Hepatic Resection-Scope for General Surgeon!

Abstract

Background: During the last decade, there has been a change in the therapeutic protocols related to liver trauma, and surgery is no longer the only option available. Aim: The aim of this study was to analyze the effectiveness and the morbidity-mortality of both conservative vs surgical treatment in a series of 50 patients with isolated hepatic injury during the last year. Method: In this retrospective study of 50 patients, variables analyzed included demographic data, injury classification, surgical treatment, transfusions, morbidity-mortality, and hospital stay. The liver trauma was classified according to the Hepatic Injury Scale of the American Association for the Surgery of Trauma. Grade I: 8 cases; grade II: 14 cases; grade III: 20 cases; grade IV: 6 cases; and grade V: 2 cases. Of 42 patients from grades 1 to 3, 37 patients were managed conservatively with the mean hospital stay of 9 days without any complications with the mean blood transfusion of 2 units. Rest of the 5 patients had to be operated due to failure of conservative trial. Five patients from grade 4 were treated conservatively with successful results. Three patients with grade 4 and 5 liver trauma were operated with 66% mortality rate. Surgical technique included limited resection-debridement, live vascular ligation, and perihepatic packing. Result: If the right determinants with accurate diagnosis are clearly defined for isolated hepatic trauma, conservative management for grades I, II, and III is the best treatment option while grades IV and V need further evaluation. HEPATIC RESECTION-SCOPE FOR GENERAL SURGEON! D Vasavada, S Mehta, S Parhad Department of Surgery, MP Shah Medical College, Jamnagar, IndiaBackground: Hepatic resection has evolved over 50 years. In India, every general surgery department has a dream for successful liver resection, in spite of the scarcity of sophisticated instrument for liver resection such as Cavitron ultrasonic surgical aspirator (CUSA), argon beam coagulator, hydro-jet dissector, and harmonic scalpel. These devices are available only in few well-set gastrointestinal and hepatobiliary pancreatic surgical units. Aim: Liver resection is possible by understanding of hepatic anatomy and precise technique. 46 patients (35%) with 12 of 16 (75%) having infectionrelated renal dysfunction, 2 (12.5%) with hypovolemia, 2 (12.5%) with HRS. Most of the mortality occurred in alcoholic cirrhosis (14 patients). Conclusion:The most common cause of renal dysfunction was infection which led to a high mortality in patients with cirrhosis. PREVALENCE OF HEPATITIS E VIRUS INFECTION AMONG PREGNANT WOMEN IN RAJASTHANV Bharadia, N Singh, S Nijhawan, RR Rai Sawai ManSingh Medical College and Hospital, Jaipur, IndiaBackground: Hepatitis E virus (HEV) is highly endemic in developing countries with high mortality rate among pregnant women. The prevalence of antibodies and RNA to HEV in Rajasthan is not known. Aim: To evaluate the prevalence of hepatitis E infection among pregnant women at the SMS Medical College and Hospital Jaipur, Raja...

Short- and long-term outcomes of surgery for colorectal and non-colorectal liver metastasis: a report from a single center in the Baltic country

“…Thus, there is a need for studies investigating short-and long-term outcomes after liver resection for non-CRLM. Moreover, the outcomes of liver surgery strongly depend on a surgeon and a hospital volume [6]. While the centralization of liver surgery in large and well-developed countries is feasible, it may remain challenging in smaller or developing countries.…”