Exploration of the appropriate operative method for severe hepatic trauma: a report of 23 cases

Objective: To explore the appropriate operative/re-operative methods and evaluate the outcomes of severe hepatic trauma.Methods: Among the 23 patients suffered from severe hepatic trauma,two patients accepted suture repair after debridement,9 patients accepted plugging repair by great omentum,8 by hepatectomy (one also treated with ribbon gauze plugging around the liver),and the other four accepted ribbon gauze plugging around the liver (two of the patients underwent secondary hepatectomy).Splenectomy was carried out for 3 patients and gastrorrhaphy was carried out for 1 patient.Results: Among the 23 patients,the hepatic trauma was graded as Ⅲ for 13 cases,Ⅳ for 8 cases,and Ⅴ for 2 cases,respectively.Twenty one patients were cured without accompanying with any complications.Two patients died.Conclusions: Operation is an effective treatment for severe hepatic trauma.The choice of operative method depends on the situation of the patient.If the surgery condition is appropriate,the hepatectomy could be the best choice for severe hepatic trauma due to the efficacy and minimum complications.