[Skip to Content]
Sign In
Individual Sign In
Create an Account
Institutional Sign In
OpenAthens Shibboleth
[Skip to Content Landing]
Article
April 1977

Postoperative Treatment of Patients After Liver Resection for TraumaA Follow-up Study

Author Affiliations

From the Department of Surgery-Trauma Center, University of California at the San Francisco General Hospital.

Arch Surg. 1977;112(4):429-435. doi:10.1001/archsurg.1977.01370040081013
Abstract

• In the last ten years, 89 hepatic resections were performed for trauma. Thirty-three patients survived and were followed up for one month to seven years: 15 patients had right lobectomy, nine left lobectomy, and nine left lateral segmentectomy. Complications were primarily pulmonary. All patients had transient derangement of liver function tests, but only three patients had liver dysfunction. Long-term follow-up showed no ill effects from the liver resection. Important postoperative treatment includes (1) adequate dependent drainage, (2) maintenance of blood volume, (3) intravenous albumin and glucose, (4) adequate nutritional support, and (5) selective use of intravenous glucagon.

(Arch Surg 112:429-435, 1977)

References
1.
Trunkey DD, Shires GT, McClelland R:  Management of liver trauma in 811 consecutive patients . Ann Surg 179:722-728, 1974.Article
2.
Lim RC Jr, Knudson J, Steele M:  Liver trauma: Current method of management . Arch Surg 104:544-550, 1972.Article
3.
Mays ET:  Lobectomy, sublobar resection, and resectional debridement for severe liver injuries . J Trauma 12:309-314, 1972.Article
4.
Blaisdell FW, Lim RC Jr:  Liver resection , in Madding GF, Kennedy PA (eds): Trauma to the Liver . Philadelphia, WB Saunders Co, 1971.
5.
Schrock T, Blaisdell FW, Mathewson C Jr:  Management of blunt trauma to the liver and hepatic veins . Arch Surg 96:698-704, 1968.Article
6.
Donovan AJ, Michaelian MJ, Yellin AE:  Anatomical hepatic lobectomy in trauma to the liver . Surgery 73:833-847, 1973.
7.
Mays ET:  Hepatic lobectomy . Arch Surg 103:216-228, 1971.Article
8.
Longmire WP Jr, Cleveland RJ:  Surgical anatomy and blunt trauma of the liver . Surg Clin North Am 52:687-698, 1972.
9.
Merendino KA, Dillard DH, Cammock EE:  The concept of surgical biliary decompression in the management of liver trauma . Surg Gynecol Obstet 117:285-293, 1963.
10.
Lucas CE, Walt AJ:  Critical decisions in liver trauma: Experience based on 604 cases . Arch Surg 101:277-283, 1970.Article
11.
Ackyroyd FW, Pollard J, McDermott WV Jr:  Massive hepatic resection in the treatment of severe liver trauma . Am J Surg 117:442-447, 1968.Article
12.
Lim RC Jr, Olcott C IV, Robinson AJ, et al:  Platelet response and coagulation changes following massive blood replacement . J Trauma 13:577-582, 1973.Article
13.
Krevans JR, Jackson DP:  Hemorrhagic disorder following massive whole blood transfusions . JAMA 159:171-177, 1955.Article
14.
Nilėhn JE, Nilsson IM, Aronsen KF, et al:  Studies on blood clotting factors in man after massive liver resection . Acta Chir Scand 133:189-195, 1967.
15.
Sheldon GF, Lim RC Jr, Blaisdell FW:  The use of fresh blood in the treatment of critically injured patients . J Trauma 15:670-677, 1975.Article
16.
Kock NG, Roding B, Hahnloser P, et al:  The effect of glucagon on hepatic blood flow: An experimental study in the dog . Arch Surg 100:147-149, 1970.Article
17.
Darle N, Lim RC Jr, Blaisdell FW:  Effect of glucagon on total liver blood flow in hemorrhagic shock . Acta Chir Scand 140:217-225, 1974.
18.
McDermott WV Jr, Greenberger NJ, Isselbacher KJ, et al:  Major hepatic resection: Diagnostic techniques and metabolic problems . Surgery 54:56-66, 1963.
19.
Silvis SE, Badertscher V:  Treatment of severe liver failure with hyperalimentation . Am J Gastroenterol 59:416-422, 1973.
20.
Blaisdell FW, Schlobohm RM:  The respiratory distress syndrome: A review . Surgery 74:251-262, 1973.
21.
Vajrabukka T, Bloom AL, Sussman M, et al:  Postoperative problems and management after hepatic resection for blunt injury to the liver . Br J Surg 26:189-200, 1975.Article
22.
Almersjö O, Bengmark S, Hafström LO, et al:  Enzyme and function changes after extensive liver resection in man . Ann Surg 169:111-119, 1968.Article
23.
Lim RC Jr, Lau G, Steele M:  Prevention of complications after liver trauma . Am J Surg 132:156-162, 1976.Article
24.
Law DK, Dudrick SJ, Abdou NI:  The effects of protein, calories, malnutrition on immunological competence of the surgical patient . Surg Gynecol Obstet 139:257-264, 1974.
25.
Bistrian BR, Blackburn GL, Hallowell E, et al:  Protein status of general surgical patients . JAMA 230:858-860, 1974.Article
26.
Cannon PR, Wisster RW, Woolridge RL, et al:  Relationship of protein deficiency to surgical infection . Ann Surg 120:514-522, 1944.Article
×