Severe XXXX : surgical strategies.

@entity1 @entity1317 @entity99 @entity204 @entity130
OBJECTIVE: To probe into effective surgical procedures and improve the outcome of treatment for @entity1 with severe @entity99 . METHODS: A retrospective study involving 113 @entity1 with severe @entity99 (AAST grade IV and V) during the past 12 years was carried out. Ninety-eight @entity1 underwent surgical treatment. Surgical interventions including hepatectomy or direct control of bleeding vessels by finger fracture technique with Pringle maneuver, selective ligation of hepatic artery, retrohepatic caval repair with total @entity99 , and perihepatic packing were mainly used. RESULTS: In the 98 @entity1 treated operatively, the survival rate was 69.4% (68/98). Among 40 @entity1 with @entity1317 ( @entity1317 ), 15 were cured with the maximum blood transfusion of 12,000 ml. Eight cases of Grade IV injury treated nonoperatively were cured. The percentage of failure of nonoperative management was 42.9% (6/14). The overall mortality rate was 32.7% (37/113), and 57% of the @entity204 were due to exsanguination. CONCLUSIONS: Reasonable surgical procedures based on classification of hepatic injuries can increase the survival rate of severe liver @entity130 . Accurate perihepatic packing is effective in dealing with @entity1317 .
