Perihepatic packing of major liver injuries: Complications and mortality

Daniel M. Caruso, Felix D. Battistella, John T Owings, Steven L. Lee, Rodney C. Samaco

Research output: Contribution to journalArticlepeer-review

64 Scopus citations

Abstract

Hypothesis: Perihepatic packs used to control hemorrhage after liver injury increase the risk of complications and this risk increases the longer packs are left in place. Design: Retrospective case series. Setting: University level I trauma center. Patients: Consecutive patients with hepatic injury. Main Outcome Measures: Liver-related complications (biliary leak and abscess), rebleeding, and mortality. Results: One hundred twenty-nine of 804 patients with liver injuries were treated with perihepatic packing. Of the 69 who survived more than 24 hours, 75% lived to hospital discharge. Mortality rates were 14% and 30% in patients with and without liver complications, respectively (P = .23). Liver complication rates were similar (P = .83) when packs were removed within 36 hours (early [33%]) or between 36 and 72 hours (late [29%]) after they were placed; the rebleeding rate was greater in the early group (21% vs 4%; P<.001). Conclusions: Liver complications associated with perihepatic packing did not affect survival. Removing liver packs 36 to 72 hours after placement reduced the risk of rebleeding without increasing the risk of liver-related complications.

Original languageEnglish (US)
Pages (from-to)958-963
Number of pages6
JournalArchives of Surgery
Volume134
Issue number9
DOIs
StatePublished - Sep 1999

ASJC Scopus subject areas

  • Surgery

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