Mays E T
Surg Gynecol Obstet. 1976 Aug;143(2):201-4.
Suturing of deep ruptures of the liver frequently produces complications of hemobilia, secondary hemorrhage and intrahepatic cavitation with sepsis and liver failure. Such complications require second and third risky operations in already critically ill patients. Such wounds should not be sutured, adequate drainage should be provided, low pressure venous bleeding should be controlled with temporary gauze tampons and arterial bleeding should be stopped by hepatic artery ligation. Such treatment obviates dangerous hepatic resections and morbid thoracoabdominal incisions and prevents hematobilia, secondary hemorrhage, intrahepatic cavitation and sepsis with hepatic failure.
肝深部破裂的缝合常常会引发诸如胆道出血、继发性出血以及肝内空洞形成并伴有败血症和肝衰竭等并发症。对于已经病情危急的患者而言，这些并发症需要进行二次甚至三次有风险的手术。此类伤口不应进行缝合，而应提供充分引流，用临时纱布填塞控制低压静脉出血，通过肝动脉结扎来止住动脉出血。这样的治疗避免了危险的肝切除术和创伤性的胸腹联合切口，并预防了胆道出血、继发性出血、肝内空洞形成以及伴有肝衰竭的败血症。
