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Arch Surg. 1999 Sep;134(9):958-62; discussion 962-3.

Perihepatic packing of major liver injuries: complications and mortality.

Author information

1
Department of Surgery, University of California, Davis, Health System, Sacramento 95817-2214, USA.

Abstract

HYPOTHESIS:

Perihepatic packs used to control hemorrhage after liver injury increase the risk of complications and this risk increases the longer packs are left in place.

DESIGN:

Retrospective case series.

SETTING:

University level I trauma center.

PATIENTS:

Consecutive patients with hepatic injury.

MAIN OUTCOME MEASURES:

Liver-related complications (biliary leak and abscess), rebleeding, and mortality.

RESULTS:

One hundred twenty-nine of 804 patients with liver injuries were treated with perihepatic packing. Of the 69 who survived more than 24 hours, 75% lived to hospital discharge. Mortality rates were 14% and 30% in patients with and without liver complications, respectively (P = .23). Liver complication rates were similar (P = .83) when packs were removed within 36 hours (early [33%]) or between 36 and 72 hours (late [29%]) after they were placed; the rebleeding rate was greater in the early group (21% vs 4%; P<.001).

CONCLUSIONS:

Liver complications associated with perihepatic packing did not affect survival. Removing liver packs 36 to 72 hours after placement reduced the risk of rebleeding without increasing the risk of liver-related complications.

PMID:
10487590
DOI:
10.1001/archsurg.134.9.958
[Indexed for MEDLINE]

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