Optimal management strategies for liver trauma: A comparative study of surgical techniques and non-operative approaches

Abstract

Background: Liver injury is commonly associated with abdominal trauma, both blunt and penetrating. Management strategies for liver trauma vary, with differing degrees of success. This retrospective single-center study aimed to compare surgical and non-operative management strategies in 54 patients with liver trauma. Methods: Patients were categorized into two groups: Group I (operative management) and Group II (conservative management). The analysis included demographic, clinical, radiological data, treatment outcomes, mortality, and hospital stay. Results: The mean age of the patients was 26±11.7 years, with a male predominance (75.93%). Surgical management was employed in 42 patients (77.78%), while 12 patients (22.22%) received conservative treatment. All patients with a negative focused assessment with sonography in trauma (FAST) were managed conservatively, showing a significant difference from those with a positive FAST. Rigid abdomen was significantly more common in the surgical group compared to the conservative group (47.62% vs. 16.67%). Additionally, 45.24% of patients in the surgical group had severe injuries, while none in the conservative group did, with a significant difference. Hemodynamic instability was also a determining factor for surgical intervention. The mortality rates were 8.33% in the conservative group and 9.52% in the surgical group. Conclusion: operative management was more commonly used than non-operative management for traumatic liver injury. Factors associated with the need for surgery included hemodynamic instability, rigid abdomen, severe injury, positive FAST, and higher liver injury grade.