What to do if you have liver damage? Treatment methods for liver damage

The problem of liver damage must never be ignored. Treatment measures should be taken as soon as possible after a clear diagnosis to avoid internal bleeding or hemorrhagic shock. Therefore, hemostatic treatment should be performed first to reduce the impact.

1. Once the diagnosis of liver laceration is confirmed, early surgical treatment should be sought. Most of the injured have internal bleeding and hemorrhagic shock, and some also have combined injuries to other organs. Preoperative anti-shock treatment is very important and can increase the patient's tolerance to anesthesia and surgery. First of all, a reliable and effective blood transfusion route should be established. It is more appropriate to choose the superior vena cava branch as the blood transfusion route. Because some injuries are combined with inferior vena cava laceration, blood transfusion from the lower limbs may be blocked or leak, and the effect of replenishing blood volume cannot be achieved. Some severe liver trauma is complicated by rupture of large blood vessels and heavy bleeding. Despite active and rapid blood transfusion, blood pressure cannot be restored and stabilized. At this time, a prompt decision should be made to perform a laparotomy while intensifying anti-shock treatment to control active bleeding, and then perform further surgical treatment when the shock improves.

2. The principles of surgical treatment of liver trauma are to stop bleeding completely, remove the lifeless fragmented liver tissue and place abdominal drainage to prevent secondary infection. Hemostasis is the key to treating liver trauma. Whether bleeding can be effectively controlled directly affects the mortality rate of liver trauma. The lifeless, fragmented liver tissue will necroticly decompose, and the accumulated blood and bile will eventually become infected and form an abdominal abscess.

3. There are many ways to stop bleeding in true liver laceration. When bleeding is heavy, you can first block the liver pedicle and then choose one of the following methods according to the specific circumstances of the injury.

1. Simple suture method is suitable for regular linear liver lacerations. Generally, 4-0 silk thread or 1-0 catgut is used through a thin round needle to make an "8"-shaped or mattress-style suture that penetrates the bottom of the wound. When tying the suture, use light and gentle force to prevent the suture from cutting the liver tissue. If there is bleeding from the needle hole, you can use hot saline gauze to apply pressure to stop the bleeding.

2. Debridement: For liver lacerations with large and deep wounds, the lifeless liver tissue should be removed first, and the broken ends of the blood vessels or bile ducts on the wound should be ligated one by one. Active bleeding points that have retracted into the liver tissue can be sutured in an "8" shape to stop bleeding. After hemostasis is completed, if there is dead space left deep in the liver wound after closure, it should not be simply closed. It can be opened and covered with a pedicled omentum or the omentum can be embedded to eliminate the dead space and then closed, and drainage can be placed.

3. If hepatic artery ligation fails to stop bleeding using the above method, ligation of the proper hepatic artery or the injured hepatic artery branch may be considered. Bleeding from the hepatic artery can achieve good hemostatic effect.