47350 Management of liver hemorrhage; simple suture of liver wound or injury

Name of the Procedure:

Management of Liver Hemorrhage; Simple Suture of Liver Wound or Injury

Summary

The procedure involves surgically suturing a wound or injury on the liver to stop bleeding and promote healing. This is a common and straightforward method to manage liver hemorrhage.

Purpose

The surgical repair of a liver wound aims to control bleeding, prevent further injury, and promote the healing of liver tissues. This is essential to restore proper liver function and prevent severe blood loss.

Indications

• Acute liver trauma due to accidents or injuries
• Uncontrolled bleeding from liver surgery or biopsies
• Liver lacerations or tears visible in imaging studies
• Patients exhibiting signs of internal bleeding, such as dizziness, low blood pressure, and rapid heart rate

Preparation

• Patients may be required to fast for 8-12 hours before the procedure.
• Medications such as blood thinners might need to be adjusted.
• Pre-operative blood tests, imaging studies (like CT scans or ultrasounds), and physical examinations are often required.

Procedure Description

1. The patient is placed under general anesthesia.
2. The surgeon makes an incision in the abdomen to access the liver.
3. The liver injury is identified, and the wound edges are brought together using specialized sutures.
4. Hemostasis (stopping the bleeding) is ensured by careful placement of the stitches.
5. The incision is closed, and dressing is applied.

Tools and equipment used include surgical sutures, hemostats, and surgical staplers. General anesthesia ensures the patient remains unconscious and pain-free during the procedure.

Duration

The procedure typically lasts between 1 to 2 hours, depending on the severity of the liver injury.

Setting

This procedure is performed in a hospital's operating room.

Personnel

• Surgeon (specialized in general or hepatobiliary surgery)
• Anesthesiologist
• Surgical nurses and technicians
• Operating room staff

Risks and Complications

• Infection at the incision site or within the abdominal cavity
• Re-bleeding from the liver wound
• Damage to surrounding organs or structures
• Anesthetic complications
• Blood clots or issues related to blood loss

Benefits

• Immediate control of bleeding
• Enhanced healing of liver tissues
• Reduction in the risk of severe blood loss and related complications
• Improved liver function and overall recovery

Recovery

• Patients may need to stay in the hospital for a few days to monitor recovery.
• Post-operative instructions include pain management, avoiding heavy lifting, and adhering to wound care guidelines.
• Recovery time can range from a few weeks to a couple of months, depending on the wound's severity and the patient’s overall health.
• Follow-up appointments are necessary to monitor healing and any potential complications.

Alternatives

• Non-surgical management with watchful waiting and monitoring, though less effective for significant bleeding.
• Angiography with embolization, an interventional radiology procedure to control bleeding.
• Pros: Less invasive than surgery. Cons: May not be suitable for large or complex liver injuries.

Patient Experience

During the procedure, the patient will be under general anesthesia and will not feel pain. Post-operatively, there may be discomfort at the incision site and in the abdomen. Pain management will be provided, typically involving medications. Most patients experience significant improvement in symptoms and liver function within weeks after surgery. Comfort measures include pain relievers, rest, and support from healthcare providers.