Blunt hepatic trauma: Comparison between surgical and nonoperative treatment

Abstract

Objective: The objective of this study is to examine the outcomes of blunt hepatic trauma, and compare surgical and nonsurgical treatment on patients admitted with hemodynamic stability and with no obvious indications of laparotomy. Methods: This is a retrospective study of cases admitted to a university teaching hospital between 2000 and 2010. In this period, 120 patients were admitted with blunt hepatic trauma. Sixty five patients (54.1%) were treated non-operatively and fifty five patients were operated upon. Patients who were to undergo surgical treatment were divided into two groups: (A) all those patients undergoing surgical treatment (55) and (B) those patients with no obvious indication for surgery (13). Results: Patients treated non-operatively had better physiological conditions on admission, had less severe injuries (except the grade of hepatic injury), received less blood components and had lower morbidity and mortality rates than patients operated upon (Group A). Patients operated upon, but with no obvious indications for surgery, had higher rates of complication and mortality than nonoperated patients. Conclusion: A non-operative approach results in lower complications, a lesser need for blood transfusions and a lower mortality rate.