A technique for emergency liver packing
Control of liver hemorrhage may present a daunting clinical scenario. Use of liver packing techniques is highly effective to control bleeding but can result in significant recurrent bleeding with pack removal. Such bleeding is particularly a problem when large portions of the hepatic parenchymal sur...
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| Published in: | Journal of gastrointestinal surgery Vol. 9; no. 2; pp. 284 - 287 |
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| Main Authors: | , , , , |
| Format: | Journal Article |
| Language: | English |
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United States
Elsevier Inc
01-02-2005
Springer Nature B.V |
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| Abstract | Control of liver hemorrhage may present a daunting clinical scenario. Use of liver packing techniques is highly effective to control bleeding but can result in significant recurrent bleeding with pack removal. Such bleeding is particularly a problem when large portions of the hepatic parenchymal surface and Glisson's capsule have been disrupted. We describe, herein, our approach to hepatic packing in scenarios where a large component of hepatic capsular disruption has occurred. Use of a non-stick bowel bag is employed on the disrupted liver surface, which, when removed, will not result in liver rebleeding. This technique has been used successfully in the management of five cases of severe liver injury with extensive capsular disruption. Familiarity with such an approach may facilitate management of similar liver injuries. |
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| AbstractList | Control of liver hemorrhage may present a daunting clinical scenario. Use of liver packing techniques is highly effective to control bleeding but can result in significant recurrent bleeding with pack removal. Such bleeding is particularly a problem when large portions of the hepatic parenchymal surface and Glisson's capsule have been disrupted. We describe, herein, our approach to hepatic packing in scenarios where a large component of hepatic capsular disruption has occurred. Use of a non-stick bowel bag is employed on the disrupted liver surface, which, when removed, will not result in liver rebleeding. This technique has been used successfully in the management of five cases of severe liver injury with extensive capsular disruption. Familiarity with such an approach may facilitate management of similar liver injuries. Control of liver hemorrhage may present a daunting clinical scenario. Use of liver packing techniques is highly effective to control bleeding but can result in significant recurrent bleeding with pack removal. Such bleeding is particularly a problem when large portions of the hepatic parenchymal surface and Glisson's capsule have been disrupted. We describe, herein, our approach to hepatic packing in scenarios where a large component of hepatic capsular disruption has occurred. Use of a non-stick bowel bag is employed on the disrupted liver surface, which, when removed, will not result in liver rebleeding. This technique has been used successfully in the management of five cases of severe liver injury with extensive capsular disruption. Familiarity with such an approach may facilitate management of similar liver injuries.[PUBLICATION ABSTRACT] |
| Author | Jin, Xiaoling Barquist, Erik Koniaris, Leonidas G. Spector, Seth A. Sitzmann, James V. |
| Author_xml | – sequence: 1 givenname: James V. surname: Sitzmann fullname: Sitzmann, James V. – sequence: 2 givenname: Seth A. surname: Spector fullname: Spector, Seth A. – sequence: 3 givenname: Xiaoling surname: Jin fullname: Jin, Xiaoling – sequence: 4 givenname: Erik surname: Barquist fullname: Barquist, Erik – sequence: 5 givenname: Leonidas G. surname: Koniaris fullname: Koniaris, Leonidas G. email: LKoniaris@med.miami.edu |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/15822214$$D View this record in MEDLINE/PubMed |
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| CitedBy_id | crossref_primary_10_1016_j_injury_2021_08_027 crossref_primary_10_1007_s00268_022_06546_5 crossref_primary_10_1007_s00268_009_0215_z crossref_primary_10_5812_atr_5392 crossref_primary_10_1186_s13017_015_0031_8 crossref_primary_10_1016_j_hbpd_2018_01_013 crossref_primary_10_1080_13651820601090489 crossref_primary_10_1007_s11605_012_1957_8 |
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| Copyright | 2005 The Society for Surgery of the Alimentary Tract The Society for Surgery of the Alimentary Tract, Inc. 2005 |
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| DOI | 10.1016/j.gassur.2004.11.003 |
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| Keywords | damage control hemangioma Liver trauma liver packing hepatocellular |
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| References | Berney, Morel, Huber (bib5) 2000; 48 Grazi, Mazziotti, Jovine (bib8) 1997; 132 Caruso, Battistella, Owings (bib4) 1999; 134 Koniaris, McKillop, Schwartz, Zimmers (bib12) 2003; 197 Reece, Maxey, Kron (bib6) 2001; 182 Feliciano, Mattox, Burch (bib3) 1986; 26 Feliciano, Rozycki (bib2) 2002; 91 Smyrniotis, Kostopanagiotou, Contis (bib7) 2003; 27 Koniaris, Hendrickson, Drugas (bib9) 2001; 136 Koniaris, Seibel, Geschwind, Sitzmann (bib1) 2003; 50 Feliciano, Mattox, Jordan (bib10) 1981; 21 Asensio, Demetriades, Chahwan (bib11) 2000; 48 |
| References_xml | – volume: 48 start-page: 349 year: 2000 end-page: 353 ident: bib5 article-title: Combined midline-transverse surgical approach for severe blunt injuries to the right liver publication-title: J Trauma contributor: fullname: Huber – volume: 50 start-page: 69 year: 2003 end-page: 72 ident: bib1 article-title: Can ethanol therapies injure the bile ducts? publication-title: Hepatogastroenterology contributor: fullname: Sitzmann – volume: 91 start-page: 72 year: 2002 end-page: 79 ident: bib2 article-title: Hepatic trauma publication-title: Scand J Surg contributor: fullname: Rozycki – volume: 134 start-page: 958 year: 1999 end-page: 962 ident: bib4 article-title: Perihepatic packing of major liver injuries: complications and mortality publication-title: Arch Surg contributor: fullname: Owings – volume: 48 start-page: 66 year: 2000 end-page: 69 ident: bib11 article-title: Approach to the management of complex hepatic injuries publication-title: J Trauma contributor: fullname: Chahwan – volume: 26 start-page: 738 year: 1986 end-page: 743 ident: bib3 article-title: Packing for control of hepatic hemorrhage publication-title: J Trauma contributor: fullname: Burch – volume: 21 start-page: 285 year: 1981 end-page: 290 ident: bib10 article-title: Intra-abdominal packing for control of hepatic hemorrhage: a reappraisal publication-title: J Trauma contributor: fullname: Jordan – volume: 27 start-page: 765 year: 2003 end-page: 769 ident: bib7 article-title: Selective hepatic vascular exclusion versus Pringle maneuver in major liver resections: prospective study publication-title: World J Surg contributor: fullname: Contis – volume: 132 start-page: 1104 year: 1997 end-page: 1109 ident: bib8 article-title: Total vascular exclusion of the liver during hepatic surgery. Selective use, extensive use, or abuse? publication-title: Arch Surg contributor: fullname: Jovine – volume: 136 start-page: 1359 year: 2001 end-page: 1362 ident: bib9 article-title: Dynamic retention: a technique for closure of the complex abdomen in critically ill patients publication-title: Arch Surg contributor: fullname: Drugas – volume: 197 start-page: 634 year: 2003 end-page: 659 ident: bib12 article-title: Liver regeneration publication-title: J Am Coll Surg contributor: fullname: Zimmers – volume: 182 start-page: 40S year: 2001 end-page: 44S ident: bib6 article-title: A prospectus on tissue adhesives publication-title: Am J Surg contributor: fullname: Kron |
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| SubjectTerms | Adult Aged damage control Female hemangioma Hemorrhage Hemorrhage - therapy hepatocellular Humans Liver Liver Diseases - therapy liver packing Liver trauma Male Middle Aged |
| Title | A technique for emergency liver packing |
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