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Open Access 01-12-2016 | Review

WSES classification and guidelines for liver trauma

Authors: Federico Coccolini, Fausto Catena, Ernest E. Moore, Rao Ivatury, Walter Biffl, Andrew Peitzman, Raul Coimbra, Sandro Rizoli, Yoram Kluger, Fikri M. Abu-Zidan, Marco Ceresoli, Giulia Montori, Massimo Sartelli, Dieter Weber, Gustavo Fraga, Noel Naidoo, Frederick A. Moore, Nicola Zanini, Luca Ansaloni

Published in: World Journal of Emergency Surgery | Issue 1/2016

Abstract

The severity of liver injuries has been universally classified according to the American Association for the Surgery of Trauma (AAST) grading scale. In determining the optimal treatment strategy, however, the haemodynamic status and associated injuries should be considered. Thus the management of liver trauma is ultimately based on the anatomy of the injury and the physiology of the patient. This paper presents the World Society of Emergency Surgery (WSES) classification of liver trauma and the management Guidelines.

Moore EE, Cogbill TH, Jurkovich GJ, Shackford SR, Malangoni MA, Champion HR. Organ injury scaling: spleen and liver (1994 revision). J Trauma. 1995;38:323–4.CrossRefPubMed

Piper G, Peitzman AB. Current management of hepatic trauma. Surg Clin N Am. 2010;90:775–85.CrossRefPubMed

Bouras AF, Truant S, Pruvot FR. Management of blunt hepatic trauma. J Visc Surg. 2010;147(6):e351–8.CrossRefPubMed

Badger SA, Barclay R, Campbell P, Mole DJ, Diamond T. Management of liver trauma. World J Surg. 2009;33:2522–37.CrossRefPubMed

Peitzman AB, Richardson JD. Surgical treatment of injuries to the solid abdominal organs: a 50-years perspective from the Journal of Trauma. J Trauma. 2010;69:1011–21.CrossRefPubMed

Coccolini F, Montori G, Catena F, Di Saverio S, Biffl W, Moore EE, Peitzman AB, Rizoli S, Tugnoli G, Sartelli M, Manfredi R, Ansaloni L. Liver trauma: WSES position paper. World J Emerg Surg. 2015;10:39.CrossRefPubMedPubMedCentral

Croce MA, Fabian TC, Menke PG, Waddle-Smith L, Minard G, Kudsk KA, Patton Jr JH, Schurr MJ, Pritchard FE. Nonoperative management of blunt hepatic trauma is the treatment of choice for hemodynamically stable patients. Results of a prospective trial. Ann Surg. 1995;221(6):744–53.CrossRefPubMedPubMedCentral

Kozar RA, Feliciano VD, Moore EE, Moore FA, Cocanour CS, West MA, Davis JW, McIntyre Jr RC. Western trauma association/critical decision in trauma: operative management of blunt hepatic trauma. J Trauma. 2011;71(1):1–5.CrossRefPubMed

American College of Surgeons. Advanced trauma life support for doctors (ATLS) student manual. 8th ed. 2008.

10.

Parks NA, Davis JW, Forman D, Lemaster D. Observation for Nonoperative management of blunt liver injuries: how long is long enough? J Trauma. 2011;70(3):626–9.CrossRefPubMed

11.

Hommes M, Navsaria PH, Schipper IB, Krige JE, Kahn D, Nicol AJ. Management of blunt liver trauma in 134 severely injured patients. Injury. 2015;46(5):837–42.CrossRefPubMed

12.

Boese CK, Hackl M, Müller LP, Ruchholtz S, Frink M, Lechler P. Nonoperative management of blunt hepatic trauma: a systematic review. J Trauma Acute Care Surg. 2015;79(4):654–60.CrossRefPubMed

13.

Kozar RA, Moore FA, Moore EE, West M, Cocanour CS, Davis J, Biffl WL, McIntyre Jr RC. Western trauma association critical decisions in trauma: nonoperative management of adult blunt hepatic trauma. J Trauma. 2009;67:1144–9.CrossRefPubMed

14.

Stassen NA, Bhullar I, Cheng JD, Crandall M, Friese R, Guillamondegui O, Jawa R, Maung A, Rohs Jr TJ, Sangosanya A, Schuster K, Seamon M, Tchorz KM, Zarzuar BL, Kerwin A, Eastern Association for the Surgery of Trauma. Non operative management of blunt hepatic injury: an Eastern association for the surgery of trauma practice management guideline. J Trauma Acute Care Surgery. 2012;73(5 Suppl 4):S288–93.CrossRef

15.

Velmhaos GC, Toutouzas KG, Radin R, Chan L, Demetriades D. Nonoperative treatment of blunt injury to solid abdominal organs. Arch Surg. 2003;138:844.CrossRef

16.

Yanar H, Ertekin C, Taviloglu K, Kabay B, Bakkaloglu H, Guloglu R. Nonoperative treatment of multiple intra-abdominal solid organ injury after blunt abdominal trauma. J Trauma. 2008;64(4):943–8.CrossRefPubMed

17.

Fang JF, Wong YC, Lin BC, Hsu YP, Chen MF. The CT risk factors for the need of operative treatment on initially stable patients after blunt hepatic trauma. J Trauma. 2006;61:547–53.CrossRefPubMed

18.

Fang JF, Chen RJ, Wong YC, Lin BC, Hsu YB, Kao JL, Kao YC. Pooling of contrast material on computed tomography mandates aggressive management of blunt hepatic injury. Am J Surg. 1998;176:315–9.CrossRefPubMed

19.

Poletti AP, Mirvis SE, Shanmuganathan K, Takada T, Killeen KL, Perlmutter D, Hahn J, Mermillod B. Blunt abdominal trauma patients: can organ injury be excluded without performing computer tomography? J Trauma. 2004;57:1072–81.CrossRefPubMed

20.

Wahl WL, Ahrns KS, Brandt MM, Franklin GA, Taheri PA. The need for early angiographic embolization in blunt hepatic injuries. J Trauma. 2002;52:1097–101.CrossRefPubMed

21.

Mohr AM, Lavery RF, Barone A, Bahramipour P, Magnotti LJ, Osband AJ, Sifri Z, Livingston DH. Angioembolization for liver injuries: low mortality, high morbidity. J Trauma. 2003;55(5):1077–81.CrossRefPubMed

22.

Stein DM, Scalea TM. Nonoperative management of spleen and liver injuries. J Int Care Med. 2006;21:296.CrossRef

23.

Letoublon C, Amariutei A, Taton N, Lacaze L, Abba J, Risse O, Arvieux C. Management of blunt hepatic trauma. J Visc Surg. 2016;153(4 Suppl):33–43.CrossRefPubMed

24.

Fabian TC, Bee TK. Ch.32 Liver and biliary tract. In: Feliciano DV, Mattox KL, Moore EE, editors. Trauma. 7th ed. United States of America: The McGraw-Hill Companies, Inc; 2008. p. 851–70.

25.

Marcheix B, Dambrin C, Cron C, Sledzianowski JF, Aguirre J, Suc B, Cerene A, Rousseau H. Transhepatic percutaneous embolisation of a post-traumatic pseudoaneurysm of hepatic artery. Ann Chir. 2004;129(10):603–6.CrossRefPubMed

26.

Harrell DJ, Vitale GC, Larson GM. Selective role for endoscopic retrograde cholangiopancreatography in abdominal trauma. Surg Endosc. 1998;12(5):400–4.CrossRefPubMed

27.

Letoublon C, Chen Y, Arvieux C, Voirin D, Morra I, Broux C, Risse O. Delayed celiotomy or laparoscopy as part of the nonoperative management of blunt hepatic trauma. World J Surg. 2008;32:1189–93.CrossRefPubMed

28.

Biffl WL, Kaups KL, Cothren CC, Brasel KJ, Dicker RA, Bullard MK, Haan JM, Jurkovich GJ, Harrison P, Moore FO, Schreiber M, Knudson MM, Moore EE. Management of patients with anterior abdominal stab wounds: a Western Trauma Association multicenter trial. J Trauma. 2009;66(5):1294–301.CrossRefPubMed

29.

Navsaria PH, Nicol AJ, Krige JE, Edu S. Selective nonoperative management of liver gunshot injuries. Ann Surg. 2009;249(4):653.CrossRefPubMed

30.

Biffl WL, Leppaniemi A. Management Guidelines for Penetrating Abdominal Trauma. World J Surg. 2015;39(6):1373–80.CrossRefPubMed

31.

Lamb CM, Garner JP. Selective non-operative management of civilian gunshot wounds to the abdomen: a systematic review of the evidence. Injury. 2014;45(4):659–66.CrossRefPubMed

32.

Biffl WL, Moore EE. Management guidelines for penetrating abdominal trauma. Curr Opin Crit Care. 2010;16(6):609–17.CrossRefPubMed

33.

Demetriades D, Hadjizacharia P, Constantinou C, Brown C, Inaba K, Rhee P, Salim A. Selective nonoperative management of penetrating abdominal solid organ injuries. Ann Surg. 2006;244(4):620–8.PubMedPubMedCentral

34.

Biffl WL, Kaups LK, Pham TN, Rowell SE, Jurkovich GJ, Burlew CC, Elterman J, Moore EE. Validating the western trauma association algorithm managing patients with anterior abdominal stable wounds: a western trauma association multi center trial. J Trauma. 2011;71(6):1494–502.CrossRefPubMed

35.

Demetriades D, Rabinowitz B. Indications for operation in abdominal stab wounds. A prospective study of 651 patients. Ann Surg. 1987;205(2):129–32.CrossRefPubMedPubMedCentral

36.

Navsaria PH, Nicol AJ, Edu S, Gandhi R, Ball CG. Selective nonoperative management in 1106 patients with abdominal gunshot wounds: conclusions on safety, efficacy, and the role of selective CT imaging in a prospective single-center study. Ann Surg. 2015;261(4):760–4.CrossRefPubMed

37.

Omoshoro-Jones JA, Nicol AJ, Navsaria PH, Zellweger R, Krige JE, Kahn DH. Selective non-operative management of liver gunshot injuries. Br J Surg. 2005;92(7):890–5.CrossRefPubMed

38.

Velmahos GC, Constantinou C, Tillou A, Brown CV, Salim A, Demetriades D. Abdominal computed tomographic scan for patients with gunshot wounds to the abdomen selected for non-operative management. J Trauma. 2005;59(5):1155–60.CrossRefPubMed

39.

Demetriades D, Velmahos G. Indication for and technique of Laparotomy. In: Moore, Feliciano, Mattox, editors. Trauma. 6th ed. New York: McGrraw-Hill; 2006.

40.

Letoublon C, Reche F, Abba J, Arvieux C. Damage control laparotomy. J Visc Surg. 2011;148(5):e366–70.CrossRefPubMed

41.

Letoublon C, Arvieux C. Traumatisme fermés du foie, Principes de technique et de tactique chirurgicales. EMC. Techniques chirurgicales – Appareil digestif, 40–785. 2003. p. 20.

42.

Strong RW, Lynch SV, Wall DR, Liu CL. Anatomic resection for severe liver trauma. Surgery. 1998;123:251–7.CrossRefPubMed

43.

Polanco P, Stuart L, Pineda J, Puyana JC, Ochoa JB, Alarcon L, Harbrecht BG, Geller D, Peitzman AB. Hepatic resection in the management of complex injury to the liver. J Trauma. 2008;65(6):1264–9.CrossRefPubMed

44.

Peitzman AB, Marsh JW. Advanced operative techniques in management of complex liver injury. J Trauma Acute Care Surg. 2012;73(3):765–70.CrossRefPubMed

45.

Richardson JD, Franklin GA, Lukan JK, Carrillo EH, Spain DA, Miller FB, Wilson MA, Polk Jr HC, Flint LM. Evolution in the management of hepatic trauma: a 25-year perspective. Ann Surg. 2000;232(3):324–30.CrossRef

46.

Frenklin GA, Casos SR. Current advances in the surgical approach to abdominal trauma. Injury. 2006;37:1143–56.CrossRef

47.

Beal SL. Fatal hepatic hemorrhage: an unresolved problem in the management of complex liver injuries. J Trauma. 1990;30:163.CrossRefPubMed

48.

Fabian TC, Croce MA, Stanford GG, Payne LW, Mangiante EC, Voeller GR, Kudsk KA. Factors affecting morbidity following hepatic trauma. A prospective analysis od 482 injuries. Ann Surg. 1991;213:540.CrossRefPubMedPubMedCentral

49.

Cue JI, Cryer HG, Miller FB, Richardson JD, Polk Jr HC. Packing and planned re-exploration for hepatic and retroperitoneal hemorrhage: critical refinements of a useful technique. J Trauma. 1990;30(8):1007.CrossRefPubMed

50.

Biffl WL, Moore EE, Franciose RJ. Venovenous bypass and hepatic vascular isolation as adjuncts in the repair of destructive wounds to the retrohepatic inferior vena cava. J Trauma. 1998;45:400–3.CrossRefPubMed

51.

Misselbeck TS, Teicher E, Cipolle MD, Pasquale MD, Shah KT, Dangleben DA, Badellino MM. Hepatic angioembolization in trauma patients:indications and complications. J Trauma. 2009;67:769–73.CrossRefPubMed

52.

Johnson JW, Gracias VH, Gupta R, Guillamondegui O, Reilly PM, Shapiro MB, Kauder DR, Schwab CW. Hepatic angiography in patients undergoing damage control laparotomy. J Trauma. 2002;52:1102–6.CrossRefPubMed

53.

Asensio JA, Petrone P, García-Núñez L, Kimbrell B, Kuncir E. Multidisciplinary approach for the management of complex hepatic injuries AAST-OIS grades IV-V: a prospective study. Scand J Surg. 2007;96(3):214–20.PubMed

54.

Dabbs DN, Stein DM, Scalea TM. Major hepatic necrosis: a common complication after angioembolization for treatement of high grade injuries. J Trauma. 2009;66:621–7.CrossRefPubMed

55.

Mohr AM, Lavery RF, Barone A, Bahramipour P, Magnotti LJ, Osband AJ, Sifri Z, Livingston DH. Angiographic embolization for liver injuries: low mortality, high morbidity. J Trauma. 2003;55(6):1077–81.CrossRefPubMed

56.

Letoublon C, Morra I, Chen Y, Monnin V, Voirin D, Arvieux C. Hepatic arterial embolization in the management of blunt hepatic trauma: indications and complications. J Trauma. 2011;70(5):1032–6.CrossRefPubMed

Title: WSES classification and guidelines for liver trauma
Authors: Federico Coccolini
Fausto Catena
Ernest E. Moore
Rao Ivatury
Walter Biffl
Andrew Peitzman
Raul Coimbra
Sandro Rizoli
Yoram Kluger
Fikri M. Abu-Zidan
Marco Ceresoli
Giulia Montori
Massimo Sartelli
Dieter Weber
Gustavo Fraga
Noel Naidoo
Frederick A. Moore
Nicola Zanini
Luca Ansaloni
Publication date: 01-12-2016
Publisher: BioMed Central
Published in: World Journal of Emergency Surgery / Issue 1/2016
Electronic ISSN: 1749-7922
DOI: https://doi.org/10.1186/s13017-016-0105-2

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WSES classification and guidelines for liver trauma

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