47360 Management of liver hemorrhage; complex suture of liver wound or injury, with or without hepatic artery ligation

Management of Liver Hemorrhage; Complex Suture of Liver Wound or Injury, with or without Hepatic Artery Ligation

Name of the Procedure:

• Common Name: Liver Hemorrhage Management
• Technical Terms: Complex Suture of Liver Wound, Hepatic Artery Ligation

Summary

This procedure is used to control bleeding in the liver due to an injury or wound. It involves suturing, or stitching, the liver tissue to stop the hemorrhage and may include tying off the hepatic artery to reduce blood flow.

Purpose

• Medical Condition: Liver hemorrhage or injury.
• Goals: To stop bleeding, repair liver tissue, and prevent further complications from liver damage.

Indications

• Severe liver injury due to trauma (e.g., car accident, sports injury).
• Uncontrolled bleeding from the liver.
• Symptoms such as significant blood loss, abdominal pain, or signs of shock.

Preparation

• Fasting for several hours before the procedure.
• Blood tests and imaging studies (e.g., CT scan) to assess the extent of the injury.
• Adjustments or cessation of certain medications as advised by the doctor.

Procedure Description

1. Anesthesia: General anesthesia is administered.
2. Incision: A surgical incision is made to access the liver.
3. Suturing: The liver wound is sutured carefully to stop bleeding.
4. Hepatic Artery Ligation (if necessary): The hepatic artery is tied off to control blood flow.
5. Closure: The incision is closed with sutures or staples.
6. Monitoring: The patient is closely monitored for bleeding and vital signs.

• Tools: Surgical sutures, clamps, possibly a cautery device.
• Technology: Imaging guidance (e.g., ultrasound).

Duration

Typically, the procedure takes about 2-4 hours, depending on the complexity of the injury.

Setting

Conducted in a hospital’s operating room.

Personnel

• Surgeon (often a trauma or liver specialist)
• Anesthesiologist
• Surgical nurses and assistants

Risks and Complications

• Common Risks: Infection, bleeding, pain at the incision site.
• Rare Risks: Liver failure, complications from anesthesia, re-bleeding, injury to surrounding organs.

Benefits

• Immediate control of life-threatening bleeding.
• Preservation of liver function.
• Improved survival rates and outcomes after severe liver injury.

Recovery

• Post-procedure care: Pain management, antibiotics to prevent infection, close monitoring in an intensive care unit (ICU).
• Recovery Time: Typically, several weeks. Restrictions on physical activity may be necessary.
• Follow-up: Scheduled visits to doctor, imaging tests to monitor healing.

Alternatives

• Non-surgical management with blood transfusions and medications (less effective for severe injuries).
• Minimally invasive procedures like angiographic embolization (used in specific cases).

Pros of Alternatives: Less invasive, shorter recovery time. Cons of Alternatives: May not be as effective for severe cases, potential need for subsequent surgery.

Patient Experience

• During the procedure: Under general anesthesia, no awareness or pain.
• After the procedure: Pain and discomfort managed with medications, presence in ICU for close monitoring, gradual improvement over weeks.
• Emotional and physical support provided by healthcare team.

By understanding the procedure in detail, patients and their families can make informed decisions about the management of liver hemorrhage and expected outcomes.