Selective Non Operative Management of Blunt Liver Trauma: Is It Still a Challenge?
Journal of Surgery
Volume 5, Issue 6, December 2017, Pages: 93-96
Received: Sep. 18, 2017; Accepted: Oct. 8, 2017; Published: Nov. 10, 2017
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Authors
Mohammed Abdallah Hablus, General Surgery Department, Faculty of Medicine, Tanta University Hospital, Tanta, Egypt
Amir Fawzy Abdelhamid, General Surgery Department, Faculty of Medicine, Tanta University Hospital, Tanta, Egypt
Mahmoud Mostafa Alsherief, General Surgery Department, Faculty of Medicine, Tanta University Hospital, Tanta, Egypt
Osama Hasan Abd-Raboh, General Surgery Department, Faculty of Medicine, Tanta University Hospital, Tanta, Egypt
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Abstract
The non-therapeutic laparotomy in managing cases with blunt liver injuries is not without risks, so selective non-operative treatment in stable patients was tried in many centers and has become the standard of care of these patients The aim of this study was to assess the feasibility and safety of selective non-operative management of blunt liver injury in our institution Patients and Methods: This prospective study was conducted on 40 patients with blunt liver injury who met our inclusion criteria admitted to Tanta University Hospital during the period from January 2012 to January 2014. All patients were treated by selective non-operative treatment (repeated clinical examination, serial U/S and CT study and follow up) Results: The age of our patients ranged from 26 to 40 years with a mean (±SD) of 31.3 ± 3.77 years. 36 patients were males (90%), while 4 patients (10%), were female. Total length of stay was ranged from 2 days to 15 days with a mean (±SD) of 5.8 ± 3.27 days as regards all cases. Intensive care unit stay was in 2 cases (5%) which FNOM with mean (±SD) of 1.5 ± 0.7 days. CT study was done in all cases (100%), 2 cases (5%) was operated after 6 hours of conservatism in ICU due to hemodynamic instability after initial assessment of stability. Conclusions: Selective non operative management of blunt liver injury in bunt abdominal trauma is safe, efficient, and cost-effective in the appropriate clinical setting and can lead to fewer unnecessary laparotomies in patients with liver injury. Proper patient selection, resources that permit close observation, and frequent abdominal examinations are paramount in obtaining the best results.
Keywords
Selective Non-operative Management, Radiological Grading, Blunt Liver Trauma
To cite this article
Mohammed Abdallah Hablus, Amir Fawzy Abdelhamid, Mahmoud Mostafa Alsherief, Osama Hasan Abd-Raboh, Selective Non Operative Management of Blunt Liver Trauma: Is It Still a Challenge?, Journal of Surgery. Vol. 5, No. 6, 2017, pp. 93-96. doi: 10.11648/j.js.20170506.12
Copyright
Copyright © 2017 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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