Klosoris E, Siedek M, Kühr J, Kozuschek W
Langenbecks Arch Chir. 1977 Jul 13;344(1):61-70. doi: 10.1007/BF01259354.
Surgical management and follow up of 85 patients with liver trauma are reported. 20 patients had only liver trauma, all others were polytraumatised. Letality was 20% in patients with sole liver trauma, the overall letality was 43%. In most cases death resulted from prolonged circulatory shock. Most of the other casualities resulted from septical complications of biliary peritonitis. Prognosis was mainly correlated with the interval between trauma and surgical treatment as well as with the amount of blood lost. The main features of the operative technic were access to the liver through a subcostal and sometimes transdiaphragmal incision, temporary tamponade of the bleeding source, compression of the hepatoduodenal ligament, of the vena cava (intrapericardial) to minimize blood loss. Instead of hemihepatectomy, resection of liver tissue was limited to the smallest amount possible, and followed by extensive drainage.
报告了85例肝外伤患者的手术治疗及随访情况。20例患者仅有肝外伤，其余均为多发伤。单纯肝外伤患者的死亡率为20%，总体死亡率为43%。多数情况下，死亡是由长时间循环休克导致的。其他多数伤亡是由胆汁性腹膜炎的感染性并发症引起的。预后主要与创伤和手术治疗之间的间隔时间以及失血量有关。手术技术的主要特点包括通过肋下切口有时还需经膈肌切口进入肝脏，对出血源进行临时填塞，压迫肝十二指肠韧带、腔静脉（心包内）以尽量减少失血量。肝组织切除仅限于尽可能小的范围，而非半肝切除术，随后进行广泛引流。
