Table of Contents Author Guidelines Submit a Manuscript
HPB Surgery
Volume 3, Issue 1, Pages 39-45
http://dx.doi.org/10.1155/1990/46171

Severe Juxtahepatic Venous Injury: Survival after Prolonged Hepatic Vascular Isolation Without Shunting

1Department of Surgery and the Medical Research Council Liver Research Center, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
2Department of Surgery, University of Cape Town, Observatory 7925, South Africa

Received 11 January 1990; Accepted 11 January 1990

Copyright © 1990 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Survival following major juxtahepatic venous injury is rare in blunt liver trauma despite the use of intracaval shunting. Prolonged liver arterial inflow control, total hepatic venous isolation and lobectomy without shunting was used in a patient to repair a combined vena caval and hepatic venous injury after blunt liver injury. An extended period of normothermic hepatic ischemia was tolerated. Early recognition of retrohepatic venous injury and temporary liver packing to control bleeding and correct hypovolemia are essential before caval occlusion. Hepatic vascular isolation without shunting is an effective simple alternative technique allowing major venous repair in complex liver trauma.