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Review article
Department of Hepatobiliary Surgery, the Second Afliated Hospital of Chongqing Medical University, Chongqing 400010, China
Department of Hepatobiliary Surgery, Shizhu Afliated Hospital, the Second Afliated Hospital of Chongqing Medical University, Chongqing 409100, China
a r t i c l e i n f o
a b s t r a c t
Article history:
Received 2 February 2015
Received in revised form
1 August 2015
Accepted 3 September 2015
Available online 10 March 2016
Liver is one of the organs with the highest injury rate, and in recent decades, the guidelines for the
treatment of liver trauma have changed considerably. Now, there is a growing consensus that the most
important step is diagnosis and depending upon the degree of severity, non-operative therapy is the
main treatment method for hepatic trauma if conditions permit. For serious hepatic trauma patients such
as those with hemodynamic instability, they should be operated upon as soon as possible. Regardless of
the surgical options, doctors should control damage to patients and try to prevent complications. New
therapies such as hepatic artery embolization and liver transplantation have been more and more used
for the treatment of serious hepatic damage in clinics.
2016 Production and hosting by Elsevier B.V. on behalf of Daping Hospital and the Research Institute of
Surgery of the Third Military Medical University. This is an open access article under the CC BY-NC-ND
license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Keywords:
Complications
Hepatic trauma
Non-operative therapy
Surgery
Introduction
Liver is a solid organ with the highest injury rate in abdominal
injury.1 Approximately 15%e20% of abdominal injuries refer to
hepatic trauma. Hepatic injury takes the third place in abdominal
injury and 80%e90% of hepatic injuries are blunt ones.2 In 2013, a
study using ultrasonography to evaluate the intraperitoneal trauma
showed that liver was the mostly affected organ and younger
people were more vulnerable to hepatic and pancreatic injury.3
In 1994, American Association for Surgery of Trauma (AAST)
proposed the standard classication of hepatic trauma. According
to the classication, level I-II hepatic trauma is called minor hepatic
trauma, accounting for 80%e90% of all hepatic trauma. The hepatic
trauma of level III and above is called serious hepatic trauma, with
the mortality of 10%, and if patients have multiple injuries, the
mortality may be elevated to as high as 25%.4 Serious hepatic
trauma is always combined with parahepatic vena cava injury, with
the mortality of above 50%.5 The treatment strategies of serious
hepatic trauma have been advanced for decades.6 The clinical
experience shows that early diagnosis, accurate assessment, active
resistance to shock, optimal treatment plan and the organ function
http://dx.doi.org/10.1016/j.cjtee.2015.09.011
1008-1275/ 2016 Production and hosting by Elsevier B.V. on behalf of Daping Hospital and the Research Institute of Surgery of the Third Military Medical University. This is
an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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