Evolution of non-operative management of liver trauma

The management of complex liver injury has changed during the last 30 years. Operative management has evolved into a non-operative management (NOM) approach, with surgery reserved for those who present in extremis or become hemodynamically unstable despite resuscitation. This NOM approach has been a...

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Bibliographic Details
Published in:Trauma surgery & acute care open 2020-11, Vol.5 (1), p.e000551-e000551
Main Authors: Brooks, Adam, Reilly, John-Joe, Hope, Carla, Navarro, Alex, Naess, Paal Aksel, Gaarder, Christine
Format: Article
Language:English
Subjects:
Abdomen
abdominal injuries
Blood transfusions
hemorrhagic
Injuries
Intensive care
Laparotomy
Liver
Medical imaging
Mortality
Pediatrics
Review
shock
Surgery
Trauma
Trauma centers
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Summary:The management of complex liver injury has changed during the last 30 years. Operative management has evolved into a non-operative management (NOM) approach, with surgery reserved for those who present in extremis or become hemodynamically unstable despite resuscitation. This NOM approach has been associated with improved survival rates in severe liver injury and has been the mainstay of treatment for the last 20 years. Patients that fail NOM and require emergency surgery are associated with increased morbidity and mortality. Better patient selection may have an impact not only on the rate of failure of NOM, but the mortality rate associated with it. The aim of this article is to review the evidence that helped shape the evolution of liver injury management during the last 30 years.
ISSN:2397-5776
2397-5776
DOI:10.1136/tsaco-2020-000551