Management of liver trauma in urban university hospitals in India: an observational multicentre cohort study

Sinha, Yash; Khajanchi, Monty; Prajapati, Ramlal; Dharap, Satish; Soni, Kapil Dev; Kumar, Vineet; Mahindrakar, Santosh; Roy, Nobhojit

doi:10.1186/s13017-020-00338-9

Cited by 6 publications

(6 citation statements)

References 28 publications

(39 reference statements)

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“…Significantly, even at higher liver injury grades such as 3, 4, and 5, these patients were nonoperatively managed, and none died. These results were similar to those of Sinha et al, with 71.2% of their patients undergoing NOM at a success rate of 90% [23]. Moreover, a prospective Saudi study by Ghnnam et al [24] that evaluated liver trauma patients over four years revealed that conservative management had a success rate of 100%.…”

Section: Discussionsupporting

confidence: 84%

Management and Outcomes of Traumatic Liver Injury: A Retrospective Analysis from a Tertiary Care Center Experience

Alanezi,

Altoijry,

Alanazi

et al. 2024

Healthcare

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Background: although liver injuries are one of the most critical complications of abdominal trauma, choosing when to operate on these injuries is challenging for surgeons worldwide. Methods: We conducted a retrospective analysis of liver injury cases at our institution from 2016 to 2022 to describe the operative and nonoperative management (NOM) outcomes in patients with traumatic liver injuries. Baseline patient characteristics, liver injury details, treatments, and outcomes were analyzed. Results: Data from 45 patients (male, 77.8%) were analyzed. The mean age was 29.3 years. Blunt trauma was the most common injury mechanism (86.7%), whereas penetrating injuries were 8.9% of cases. Conservative management was associated with 18.9% of complications. The overall complication rate was 26.7%; delirium and sepsis were the most common (13.3%), followed by acute renal failure (4.4%), pneumonia, biliary leaks, and meningitis/seizures. Conclusions: Notwithstanding its limitations, this retrospective analysis demonstrated that NOM can serve as a safe and effective strategy for hemodynamically stable patients with liver trauma, irrespective of the patient’s injury grade. Nevertheless, careful patient selection and monitoring are crucial. Further investigations are necessary to thoroughly evaluate the management of traumatic liver injuries, particularly in the context of multiorgan injuries.

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Section: Discussionsupporting

confidence: 84%

Management and Outcomes of Traumatic Liver Injury: A Retrospective Analysis from a Tertiary Care Center Experience

Alanezi,

Altoijry,

Alanazi

et al. 2024

Healthcare

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“…However, laparoscopy as an initial approach for liver trauma is not recommended. Currently, the majority of patients with blunt liver trauma, especially children, were treated with a nonoperative management strategy, while those with hemodynamic instability and nonresponsiveness should undergo an operation (8,9). Other indications for an operation were some complications associated with nonoperative management strategies, such as hemorrhage, bile peritonitis, abdominal compartment syndrome, and liver compression (10).…”

Section: Discussionmentioning

confidence: 99%

Management of liver trauma by laparoscopy using infrahepatic inferior vena cava partial clamping: A case report

Zhang

Tan²,

Zheng³

et al. 2023

Front. Surg.

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Liver trauma with hemodynamic instability is extremely dangerous. Exploratory surgery after fluid resuscitation is a potentially effective method to save lives. Although there have been great advances in laparoscopic techniques for hepatectomy, laparoscopy is rarely used for liver trauma. According to our previous experience, laparoscopic infrahepatic inferior vena cava (IVC) clamping was a safe and effective technique to reduce central venous pressure (CVP) and control bleeding during hepatectomy. In this article, we described a case of grade V liver trauma that had been managed by an entirely laparoscopic approach using infrahepatic IVC partial clamping, outlining the technique of laparoscopy for liver trauma and the postoperative outcomes.

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“… 7 Depending on the velocity of injury the severity might be diverse, ranging from simple abdominal abrasions to life-threatening organ injury which needs prompt intervention and even with best efforts might even result in death. 8 …”

Section: Discussionmentioning

confidence: 99%

Blunt Abdominal Trauma among Patients Admitted to the Department of Surgery at a Tertiary Care Centre: A Descriptive Cross-sectional Study

Ghimire¹,

Acharya²,

Pudasaini³

et al. 2023

J Nepal Med Assoc

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Introduction: Blunt abdominal trauma bears significant morbidity and mortality worldwide and needs careful evaluation and management for a better outcome, where the resources are limited and the impact of the financial burden is very important. Previously, many cases used to be managed with operative procedures, and now the trend has been shifting to non-operative management. This study aimed to determine the prevalence of blunt abdominal trauma among patients admitted to the Department of Surgery of a tertiary care centre. Methods: This was descriptive cross-sectional study done between 1 February 2022 to 31 January 2023 after taking ethical approval from the Institutional Review Committee (Reference number: 2312202103). The decision of non-operative versus operative treatment was decided with dynamic clinical evaluation and severity of intraabdominal injuries. Demographic data, the mechanism of injury, and both conservative and operative management were studied. All the patients who were more than 18 years of age, and admitted to the Department of Surgery were included in the study. Convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Results: Among a total of 1450 patients, the prevalence of blunt abdominal trauma was 140 (9.65%) (8.13-11.17, 95% Confidence Interval). A total of 61 (43.57%) were young within the age group of 18-30 with a male-female ratio of 4:1. Road traffic accidents 79 (56.43%) were the most common mechanism followed by falls from heights 51 (36.43%). Conclusions: The prevalence of blunt abdominal trauma among patients admitted to the Department of Surgery was found to be higher than in other studies done in similar settings.

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Management of liver trauma in urban university hospitals in India: an observational multicentre cohort study

Cited by 6 publications

References 28 publications

Management and Outcomes of Traumatic Liver Injury: A Retrospective Analysis from a Tertiary Care Center Experience

Management and Outcomes of Traumatic Liver Injury: A Retrospective Analysis from a Tertiary Care Center Experience

Management of liver trauma by laparoscopy using infrahepatic inferior vena cava partial clamping: A case report

Blunt Abdominal Trauma among Patients Admitted to the Department of Surgery at a Tertiary Care Centre: A Descriptive Cross-sectional Study

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