April 1966

Hepatectomy for Severe Liver Injury

Author Affiliations

From the Price Institute of Surgical Research, Department of Surgery, University of Louisville School of Medicine, and the Department of Surgery, Louisiana State University School of Medicine.

Arch Surg. 1966;92(4):636-642. doi:10.1001/archsurg.1966.01320220192030

TRAUMA to the liver is an increasingly common problem. While substantial progress has been made in the management of penetrating wounds, the mortality following blunt injuries has remained high, well over 50% despite antibiotics, transfusion, and use of other modern adjuncts to surgery. This figure is even more alarming when one contemplates the steady increase in this type of trauma produced by vehicular accidents.1,2,3

The concern over the lack of progress in this area, the controversy over the role of the liver in shock, and the intolerance of patients and animals with damaged livers to shock form the basis of this study.

Clinical Background  A review of 309 cases of liver injuries at Charity Hospital of Louisiana (1942-1959) revealed blunt trauma to be responsible for 108 cases (36%); the other 201 cases were due to gunshot and stab wounds. The overall mortality for the group of patients with

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