PMID: 9555844Apr 29, 1998Paper

Selective application of laparoscopy and fibrin glue in the failure of nonoperative management of blunt hepatic trauma

The Journal of Trauma
R J ChenM F Chen

Abstract

Most blunt hepatic trauma patients can be managed nonoperatively. The current failure rate in adult blunt hepatic trauma is reportedly 0 to 19%. We wished to evaluate the applicability of laparoscopy and fibrin glue as a minimally invasive alternative to laparotomy in these unsuccessfully nonoperative cases. All adult patients with blunt hepatic trauma managed nonoperatively at Linkou, Chang Gung Memorial Hospital Medical Center, Taipei, Taiwan, over a 2-year period from July 1, 1994, to June 30, 1996, were eligible for the study. A laparoscopic examination was performed on those who failed conservative care before undertaking an exploratory laparotomy. Fibrin glue was sprayed over the wound surface if ongoing hemorrhage was evident from any liver laceration. The clinical data, operative and laparoscopic findings, operative methods, and outcomes of these patients were studied. Of the 61 patients, 55 patients were successfully treated without operation. Of the six failures (10%) all were liver related. After the introduction of laparoscopy, the nontherapeutic laparotomy rate would have decreased from 100% (6 of 6) to 50% (3 of 6), and with the adjunctive use of fibrin glue, the laparotomy rate went down to 0% (0 of 6). There wer...Continue Reading

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Citations

Oct 13, 2006·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·H P BeckerR Schwab
Apr 15, 2004·Injury·Elias DegiannisMartin D Smith
Jul 13, 1999·Journal of the American College of Surgeons·R T Villavicencio, J A Aucar
Dec 10, 2002·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Dirk W Meijer
Jul 12, 2003·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Antonio IannelliJean Gugenheim
Nov 18, 2003·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Pascal FabianiJ Gugenheim
Apr 29, 1998·Journal of Women's Health
Jun 25, 2002·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Piotr J GoreckiGerald W Shaftan
Dec 22, 2007·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Amulya K Saxena, Cornelia van Tuil
Sep 2, 2006·World Journal of Emergency Surgery : WJES·Oliver WarrenAra Darzi
Feb 19, 2010·World Journal of Surgery·Heng-Fu LinHsin-Chin Shih
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Jan 12, 2021·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Luca PauGiovanni Dapri
Mar 2, 2021·Curēus·Dipak LimbachiyaHardik D Desai

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