Hepatectomy During the Pandemic, a Curative Treatment in High-Grade and/or Hemodynamically Unstable Blunt Liver Trauma.

Current health sciences journal Pub Date : 2023-01-01 Epub Date: 2023-03-31 DOI:10.12865/CHSJ.49.01.123
Gheorghe-Jean Boldea, Eugen Florin Georgescu, Ion Georgescu, Dumitru Rădulescu, Mircea Pîrșcoveanu
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Abstract

The liver is among the most affected organs in the case of abdominal trauma. In the last decades there have been significant changes in therapeutic protocols, non-operative management is now the first intention in most cases due to good results offered previously. In high-grade or hemodynamically unstable injuries, hepatectomy is the best approach, even though this was viewed with skepticism in the past, technical advances in medicine have proven otherwise. This article presents a case report of a 29-year-old man with blunt abdominal trauma, who initially underwent conservative atypical right hepatectomy without a favourable outcome, later he was transferred to a liver transplant center where he underwent a controlled right hepatectomy, all this in a new epidemiological context, the COVID-19 Pandemic. We want to present the hypothesis that in making a therapeutic decision, the hemodynamic status of the patient must be considered equally along with the injury degree. This case represents an opportunity to review the role of liver resection in the management of complex liver injuries.

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大流行病期间的肝切除术,对高级别和/或血液动力学不稳定的钝性肝损伤的治疗。
在腹部创伤的情况下,肝脏是受影响最严重的器官之一。在过去的几十年里,治疗方案发生了重大变化,由于之前提供的良好结果,非手术治疗现在是大多数情况下的首选。在高级别或血液动力学不稳定的损伤中,肝切除术是最好的方法,尽管过去人们对此持怀疑态度,但医学的技术进步已经证明并非如此。本文报告了一名29岁男子的病例报告,他患有钝性腹部创伤,最初接受了保守的非典型右肝切除术,但没有良好的结果,后来被转移到肝脏移植中心,在那里他接受了控制性右肝切除手术,所有这一切都是在新的流行病学背景下进行的,即新冠肺炎大流行。我们想提出这样一个假设,即在做出治疗决定时,患者的血液动力学状态必须与损伤程度同等考虑。本病例为回顾肝切除术在复杂肝损伤治疗中的作用提供了机会。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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