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This volume is a complete manual of operative techniques for battling a severe liver injury. It provides an easy pre-operative and intra-operative reference with clear illustrations, line drawings as well as actual intra-operative color pictures, supplemented by online video segments. The early sections of the book deal with the fundamentals of surgical anatomy and critical maneuvers in the resuscitation of the patient in extremis. The various technical maneuvers for manual control of hemorrhage, debridement-resection as well as formal lobectomy of the liver, the identification of biliary tract injuries and other miscellaneous techniques, such as balloon tamponade of missile tracts, are discussed in complete detail. The book also sketches the role of liver transplantation surgeons in the acute trauma setting. The final chapters focus on the urgent problem of teaching operative techniques to young trauma surgeons in an era of dwindling surgical experience.
Written by authors who are world- renowned experts in trauma management, often termed “master-surgeons”, Operative Techniques for Severe Liver Injury is required preparation for all surgeons who are likely to face a massive crush injury of the liver.
Table of Contents
1 Surgical Anatomy of the Liver . 1
Thomas M. Scalea and Brandon R. Bruns
2 Treatment of Liver Injuries: An Overview . 9
Charles E. Lucas and Anna M. Ledgerwood
3 Resuscitation Maneuvers for “Extremis” . 29
Thomas M. Scalea
4 Massive Hepatic Hemorrhage: Identification . . . . . . . . . . . . . . 35
Adrian W. Ong, Vicente Cortes, and Aurelio Rodriguez
5 Massive Hepatic Hemorrhage:
Initial Steps in Hemostasis . 41
Juan A. Asensio, Juan Manuel Verde, Patrizio Petrone,
Alejandro J. Pérez-Alonso, Corrado Marini,
and Anthony Policastro
6 Liver Trauma: Parenchymal Repair
and Resectional Debridement 57
H. Leon Pachter and S. Rob Todd
7 Parenchyma: Formal Lobectomy 67
Andrew B. Peitzman and James Wallis Marsh
8 Vascular Injuries of Porta Hepatis 79
Jordan A. Weinberg and Timothy C. Fabian
9 Juxtahepatic Venous Injuries . 85
L.D. Britt
10 Juxtahepatic Venous Injuries: Emergency Measures,
Definitive Control, and Atriocaval Shunts 95
Donald D. Trunkey and K. Shad Pharaon
11 Long Penetrating Tracts . 103
Rao R. Ivatury
12 Liver Packing . 107
David V. Feliciano
13 Damage Control Laparotomy 117
Carlos A. Ordoñez, Mauricio Millán,
and Michael W. Parra
14 Liver Resection and Transplantation for Trauma
by Transplant Surgeons 125
Salvatore Gruttadauria, Duilio Pagano, and Marco Spada
15 Extrahepatic Biliary System 131
David V. Feliciano
16 Acquisition of Surgical Skills in Animal and Simulation
Laboratories 143
Robert F. Buckman Jr. and Mark W. Bowyer
17 Acquisition of Surgical Skills by Hepatobiliary Rotation . 157
Brian G. Harbrecht and J. David Richardson
Index 161
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