Il “damage control” nel trattamento di gravi lesioni epatiche: nostra esperienza


COD: 2003_05_529-534 Categorie: ,

G. Tugnoli, M. Casali, S. Villani, A. Biscardi, A. Borrello, F. Baldoni

Ann. Ital. Chir., LXXIV, 5, 2003

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Purpose: To evaluate our 12-year experience in the treat ment of complex hepatic injuries with periepatic packing and damage control priciples
Method: A retrospective review was conducted of 21 Partients with grade IV-V injuries of the liver and severe haemorrage induced hypothermia and acidosis admitted to the Ospedale Maggiore Trauma Center in Bologna from 1989 to 2001
Results: All the Patients had major blunt trauma. Mean age was 39,6; mean ISS 41,5; mean RTS 4,13; extimated loss of blood was greater than 5300 ml. Packing provide definitive control of bleeding in 16 Patients but 10 had recurrent bleeding or bleeding from different injuries such as bone fractures and required further surgery (2) or arterial embolization (8). 12 Patients died (57,2%). Survival was strongly associated with the ISS, GCS, the loss of blood and acidosis.