The following is a summary of “Delayed versus early hepatic resection among patients with severe traumatic liver injuries undergoing damage control laparotomy,” published in the December 2023 issue of Surgery by Hosseinpour, et al.
For a study, researchers sought to assess the impact of the timing of hepatic resection on outcomes among patients with severe liver injuries who underwent damage control laparotomy (DCL).
A retrospective analysis spanning four years (2017–2020) of data from the American College of Surgeons Trauma Quality Improvement Program (ACS-TQIP) was conducted. Adult trauma patients with severe liver injuries (AAST-OIS grade ≥ III) who underwent DCL and hepatic resection were included, with exclusion criteria applied to patients with early mortality (<24 h). Patients were categorized into those who underwent hepatic resection during the initial operation (Early) and those who had resection during a subsequent take-back operation (Delayed).
Out of 914 patients identified, 29% underwent delayed hepatic resection. Multivariable regression analysis revealed that delayed resection was not associated with mortality (adjusted odds ratio [aOR]: 1.060, 95% CI [0.57–1.97], P = 0.854). However, delayed resection was associated with higher rates of complications (aOR: 1.842, 95% CI [1.38–2.46], P < 0.001) and longer hospital (β: +0.129, 95% CI [0.04–0.22], P = 0.005) and ICU (β: +0.198, 95% CI [0.14–0.25], P < 0.001) lengths of stay compared to early resection.
Delayed hepatic resection in patients with severe liver injuries who underwent DCL was not associated with increased mortality but was correlated with higher rates of major complications and prolonged hospital and ICU lengths of stay compared to early resection.
Reference: americanjournalofsurgery.com/article/S0002-9610(23)00303-3/abstract