Treatment Outcomes of Non-operative Management for Traumatic Liver Injury

Abstract

【Background】 Today, the cornerstone of treatment for traumatic liver injury is non-operative management (NOM). This study clarified the treatment outcomes of traumatic liver injury in the NOM era. 【Method】In this multicenter study, we retrospectively analyzed the data of patients with traumatic liver injury seen from January 2010 to December 2015. 【Results】 There were 239 patients (age 39.6±23.2 years; 55 males) from 16 centers. The severity of the liver injury was classified according to the Japanese Association for the Surgery of Trauma, as Ⅰa：Ⅰb：Ⅱ：Ⅲa：Ⅲb in 38：101：24：23：53 patients. The most frequent cause was traffic injury. The first selected treatment was damage control surgery (DCS) in 11 patients, transcatheter arterial embolization (TAE) in 32 patients, and conservative treatment in 196 patients. Nine patients who initially received conservative treatment subsequently underwent TAE (n＝2), endoscopic retrograde biliary drainage (n＝1), or surgery (n＝6), and six patients who initially received interventional radiology subsequently underwent surgery. The mortality rate was 7.9％ (n＝19; death from bleeding in 8 patients and from critical injury of other organ (s) in 11 patients). The rate of late complications was 2.5％. 【Conclusion】This study clarified the treatment outcomes of traumatic liver injury in the NOM era.