Retrohepatic vein injuries: Experience with 20 cases

Kennan J. Buechter, Dexter J. Sereda, Gerardo Gomez, Robert Zeppa

Research output: Contribution to journalArticle

27 Scopus citations

Abstract

The mortality for injury of the retrohepatic veins is reported to vary from 50 to 100%. The use of hepatic bypass techniques, introduced in the 1960’s, has not significantly decreased this mortality. We reviewed our experience with liver injuries over a 5-year period from 1982 to 1987 to determine our results with these particular injuries. Twenty patients had retrohepatic vein injuries. There were 11 patients with penetrating trauma and nine with blunt trauma. A total of 15 patients died, for a mortality rate of 75%. Fourteen patients died intraoperatively from exsanguination and one postoperatively from sepsis. A shunt was used in an attempt to bypass the injury in ten patients, with nine deaths. In the ten remaining patients who were not shunted, there were six deaths. Thus, in ten shunted patients the mortality was 90% and in ten non-shunted patients, 60%.Our review supports other studies reporting a lower mortality by direct exposure and repair of retrohepatic vein injuries. Although total vascular occlusion of the liver may not be well tolerated in hypotensive patients, rapid application of the above approach resulted in better patient survival than the use of shunts.

Original languageEnglish (US)
Pages (from-to)1698-1704
Number of pages7
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume29
Issue number12
DOIs
StatePublished - Dec 1989

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

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