Utility of the Glissonean Pedicle Ligation Method as the New Optional Surgical Technique for Severe Liver Trauma

Abstract

The most common treatment strategy for severe liver trauma at present is perihepatic gauze packing as damage control and complementary arterial embolization for hemostasis after surgery via a catheter. However, we sometimes encounter cases that cannot be adequately treated only with this strategy, and it is hard to say that the mortality rate of severe liver trauma is satisfactorily low. In the present article we introduce the Glissonean pedicle ligation method as the new optional surgical technique for severe liver trauma. This method has been developed to perform a hepatectomy for liver cancer more safely and easily. We have to date applied this procedure in 6 cases of type Ⅲb liver trauma (2 cases as damage control, and 4 cases definitive surgery for acute hepatic necrosis after resuscitative TAE). All the patients recovered completely and were ultimately discharged. Although there are some problems and restrictions in carrying out this procedure universally, it may be useful for patients with severe liver trauma.