{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T22:44:29Z","timestamp":1769035469045,"version":"3.49.0"},"reference-count":32,"publisher":"Walter de Gruyter GmbH","issue":"1","license":[{"start":{"date-parts":[[2019,1,1]],"date-time":"2019-01-01T00:00:00Z","timestamp":1546300800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,5,21]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_med-2019-0038_s_007\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>According to the National Trauma Data Bank, the liver, after the spleen, is the first most injured organ in closed abdominal trauma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_med-2019-0038_s_008\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>From June 2010 to December 2015 we observed in our department of Hepato-biliary Surgery and Liver Transplant Unit of the A.O.R.N. A. Cardarelli of Naples 40 patients affected by hepatic trauma. In our retrospective study, we review our experience and propose portal vein ligation (PVL) as a first \u2013 line strategy for damage control surgery (DCS) in liver trauma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_med-2019-0038_s_009\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>26\/40 patients (65%) which received gauze-packing represented our study group. In 10 cases out of 26 patients (38,4%) the abdominal packing was enough to control the damage. In 7 cases (18,4%) we performed a liver resection. In 7 cases, after de-packing, we adopted PVL to achieve DCS. Trans Arterial Embolization was chosen in 6 patients. 2 of them were discharged 14 days later without performing any other procedure.<\/jats:p>\n                    <jats:p>In 3 cases we had to perform a right epatectomy in second instance. Two hepatectomies were due to hemoperitoneum, and the other for coleperitoneum. Two patients were treated in first instance by only doing hemostasis on the bleeding site. We observed 6 patients in first instance. Five of them underwent surgery with hepatic resection and surgical hemostasis of the bleeding site. The other one underwent to conservative management. In summary we performed 15 hepatic resections, 8 of them were right hepatectomies, 1 left hepatectomy, 2 trisegmentectomies V-VI-VII. So in second instance we operated on 10 patients out of 34 (30%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_med-2019-0038_s_010\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The improved knowledge of clinical physio-pathology and the improvement of diagnostic and instrumental techniques had a great impact on the prognosis of liver trauma. We think that a rigid diagnostic protocol should be applied as this allows timely pathological finding, and consists of three successive but perfectly integrated steps: 1) patient reception, in close collaboration with the resuscitator; 2) accurate but quick diagnostic framing 3) therapeutic decisional making. Selective portal vein ligation is a well-tolerated and safe manoeuvre, which could be effective, even if not definitive, in treating these subjects. That is why we believe that it can be a choice to keep in mind especially in post-depacking bleeding.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/med-2019-0038","type":"journal-article","created":{"date-parts":[[2019,5,23]],"date-time":"2019-05-23T05:04:22Z","timestamp":1558587862000},"page":"376-383","source":"Crossref","is-referenced-by-count":6,"title":["Management of complications of first instance of hepatic trauma in a liver surgery unit: Portal vein ligation as a conservative therapeutic strategy"],"prefix":"10.1515","volume":"14","author":[{"given":"Aldo","family":"Rocca","sequence":"first","affiliation":[{"name":"Department of Translational Medical Sciences, University of Naples \u201cFederico II\u201d , Naples , Italy"},{"name":"Via Sergio Pansini, 80131 Naples , Italy General Surgery Unit, Clinica Padre Pio, Mondragone (CE), Italy Department of Abdominal Oncology, Fondazione Giovanni Pascale, IRCCS , Naples , Italy"},{"name":"Centre of Hepatobiliarypancreatic surgery, Pineta Grande Hospital , Castelvolturno (CE) , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enrico","family":"Andolfi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of general Surgery, San Donato Hospital , via Pietro Nenni 20-22, 52100 Arezzo , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna Ginevra Immacolata","family":"Zamboli","sequence":"additional","affiliation":[{"name":"General Surgery Unit, De Luca E Rossano Hospital , Vico Equense (NA) , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Surfaro","sequence":"additional","affiliation":[{"name":"General Surgery Unit, Ospedale del Mare , Naples , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Domenico","family":"Tafuri","sequence":"additional","affiliation":[{"name":"Department of Sport Sciences and Wellness, University of Naples \u201cParthenope\u201d , Naples , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianluca","family":"Costa","sequence":"additional","affiliation":[{"name":"Surgical and Medical Department of Traslational Medicine, Sapienza University of Rome, Sant\u2019Andrea Hospital , Via di Grottarossa 1035-39, 00189 Rome , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara","family":"Frezza","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of general Surgery, San Donato Hospital , via Pietro Nenni 20-22, 52100 Arezzo , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Scricciolo","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of general Surgery, San Donato Hospital , via Pietro Nenni 20-22, 52100 Arezzo , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maurizio","family":"Amato","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine and Surgery, University Federico II of Naples . Naples , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"Bianco","sequence":"additional","affiliation":[{"name":"Centre of Hepatobiliarypancreatic surgery, Pineta Grande Hospital , Castelvolturno (CE) , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sergio","family":"Brongo","sequence":"additional","affiliation":[{"name":"Plastic Surgery Unit, Department of Medicine, Surgery and Dentistry \"Scuola Medica Salernitana\", San Giovanni di Dio e Ruggi D'Aragona University Hospital, University of Salerno , Salerno , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Graziano","family":"Ceccarelli","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of general Surgery, San Donato Hospital , via Pietro Nenni 20-22, 52100 Arezzo , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Giuliani","sequence":"additional","affiliation":[{"name":"Department of Transplantation, Unit of Hepatobiliary Surgery and Liver Transplant Center, \u2018A. Cardarelli\u2019 Hospital , Naples , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruno","family":"Amato","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine and Surgery, University Federico II of Naples . Naples , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2019,5,21]]},"reference":[{"key":"2026012107364008795_j_med-2019-0038_ref_001","doi-asserted-by":"crossref","unstructured":"Kozar R.A.: Western Trauma\/Critical decision in Trauma: Operative Management of Adult Blunt Hepatic Trauma.The journal of trauma Injury, Infection and Critical Care-July 2011, Vol 71,n.1","DOI":"10.1097\/TA.0b013e318220b192"},{"key":"2026012107364008795_j_med-2019-0038_ref_002","doi-asserted-by":"crossref","unstructured":"S\u00e0nchez Bueno F: Cambios en el manejo diagnostico-terapeutico del traumatismo hep\u00e0tico. 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