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10.11.2020 | Original Article

Early re-laparotomy for patients with high-grade liver injury after damage-control surgery and perihepatic packing

verfasst von: Byung Hee Kang, Kyoungwon Jung, Donghwan Choi, Junsik Kwon

Erschienen in: Surgery Today | Ausgabe 6/2021

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Abstract

Purpose

The likelihood of re-bleeding after damage-control surgery (DCS) and perihepatic packing for high-grade liver injuries is a major concern. Thus, although early re-laparotomy tends to be recommended, we conducted this study to evaluate the feasibility of performing definite laparotomy within ≤ 48 h in this clinical population.

Methods

The subjects of this retrospective study were 65 patients (n = 24, ≤ 48-h group; n = 41, > 48-h group) who underwent DCS and perihepatic packing. The primary outcome was the rate of repacking for bleeding during re-laparotomy and the secondary outcomes were mortality and length of stay in the intensive care unit (ICU).

Results

The ≤ 48-h group had a higher rate of angioembolization and transfusion of red blood cells (RBCs), fresh frozen plasma, and platelets, but the rates of repacking and mortality were not significantly different between the groups. However, the incidence of pneumonia and ventilation support requirement were significantly lower in the ≤ 48-h group than in the > 48-h group.

Conclusion

The re-laparotomy performed within ≤ 48 h after DCS and perihepatic packing is feasible for patients with high grade liver injury, using angioembolization and aggressive transfusion, as required. Early re-laparotomy reduces the need for prolonged ventilator support and the incidence of ventilator-associated pneumonia.

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Titel: Early re-laparotomy for patients with high-grade liver injury after damage-control surgery and perihepatic packing
verfasst von: Byung Hee Kang
Kyoungwon Jung
Donghwan Choi
Junsik Kwon
Publikationsdatum: 10.11.2020
Verlag: Springer Singapore
Erschienen in: Surgery Today / Ausgabe 6/2021
Print ISSN: 0941-1291
Elektronische ISSN: 1436-2813
DOI: https://doi.org/10.1007/s00595-020-02178-1

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Abstract

Purpose

Methods

Results

Conclusion

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