Utility of Glissonean Pedicle Transection for Surgical Treatment of Severe Liver Trauma
| Autor: | Junichi Matsumoto, Satoshi Koizumi, Shinjiro Kobayashi, Kenta Katsumata, Kouhei Segami, Shigeki Fujitani, Tatsunori Ono, Hiroyuki Hoshino, Masafumi Katayama, Yasuhiko Taira, Takehito Otsubo |
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| Rok vydání: | 2017 |
| Předmět: |
Damage control
medicine.medical_specialty Damage control surgery Liver trauma business.industry Glissonean pedicle ligation medicine.medical_treatment Gastroenterology 030208 emergency & critical care medicine medicine.disease Surgery 03 medical and health sciences 0302 clinical medicine Hemostasis medicine Definitive surgery Case Series lcsh:Diseases of the digestive system. Gastroenterology lcsh:RC799-869 Hepatectomy Liver cancer Surgical treatment Ligation business |
| Zdroj: | Case Reports in Gastroenterology, Vol 11, Iss 1, Pp 190-200 (2017) Case Reports in Gastroenterology |
| ISSN: | 1662-0631 |
| Popis: | The most common initial strategy for treatment of severe liver trauma is damage control in which hemostasis is achieved by perihepatic gauze packing and/or vascular embolization. However, we encounter patients in whom this strategy alone is not adequate. We have applied the principles of Glissonean pedicle transection, a technique that was originally devised to ensure safe and quick performance of planned hepatectomy for liver cancer, to 3 cases of severe liver trauma. We performed Glissonean pedicle ligation during damage control surgery in 2 patients and Glissonean pedicle transection during the definitive surgery in 1 patient. We describe the approaches and our experience with them, including operation times and outcomes. From our experience thus far, it seems that 8–12 h after the damage control procedure is appropriate for performing the definitive surgery. Although there are some problems posed by this strategy and cases to which it will not be applicable, the method seems to be particularly useful for cases of severe liver trauma in which the damage is extensive and involves the Glissonean pedicles near the hepatic hilus. We describe our 3 cases in detail and review our experience in light of the available literature. |
| Databáze: | OpenAIRE |
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