Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2022
Management of hepatic artery trauma during hepato-pancreato-biliary procedures: Evolving approaches, clinical outcomes, and literature review.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Atay Arif, Gungor Feyyaz, Sur Yunus, Gunes Orgun, Dilek Fatma Husniye, Karasu Şebnem, Dilek Osman Nuri
Аннотация
BACKGROUND: One of the most feared complications of surgeons dealing with hepato-pancreato-biliary (HPB) surgery is hepatic artery (HA) injury. Here, we aimed to evaluate our clinical experience (laceration, transection, ligation, and resection) related to HA traumas, which have serious morbidity and mortality risks, in the light of literature data and the rapidly evolving management methods in recent years.
METHODS: The files of 615 patients who were operated on for HPB pathologies in the last decade, in our hospital, were retrospectively reviewed. Clinical, laboratory, and imaging data obtained from patients' files were evaluated.
RESULTS: A total of 13 HA traumas were detected, eight of them had HA injury and five had planned HA resection. During the post-operative follow-up period, liver abscess, anastomotic leakage, and late biliary stricture were detected.
CONCLUSION: Complications and deaths due to HA injury or ligation are less common today. The risk of complications increases in patients with hemodynamically unstable, jaundice, cholangitis, and sepsis. Revealing the variations in the pre-operative radiological evaluation and determining the appropriate approach plan will reduce the risks. In cases where HA injury is detected, arterial flow continuity should be tried to be maintained with primary anastomosis, arterial transpositions, or grafts.
METHODS: The files of 615 patients who were operated on for HPB pathologies in the last decade, in our hospital, were retrospectively reviewed. Clinical, laboratory, and imaging data obtained from patients' files were evaluated.
RESULTS: A total of 13 HA traumas were detected, eight of them had HA injury and five had planned HA resection. During the post-operative follow-up period, liver abscess, anastomotic leakage, and late biliary stricture were detected.
CONCLUSION: Complications and deaths due to HA injury or ligation are less common today. The risk of complications increases in patients with hemodynamically unstable, jaundice, cholangitis, and sepsis. Revealing the variations in the pre-operative radiological evaluation and determining the appropriate approach plan will reduce the risks. In cases where HA injury is detected, arterial flow continuity should be tried to be maintained with primary anastomosis, arterial transpositions, or grafts.