Document Type
Article
Publication Date
8-1-2024
Identifier/URL
40930300 (Pure); 38553335 (PubMed)
Abstract
Background: High-grade liver injuries with extravasation (HGLI + Extrav) are associated with morbidity/mortality. For low-grade injuries, an observation (OBS) first-strategy is beneficial over initial angiography (IR), however, it is unclear if OBS is safe for HGLI + Extrav. Therefore, we evaluated the management of HGLI + Extrav patients, hypothesizing IR patients will have decreased rates of operation and mortality. Methods: HGLI + Extrav patients managed with initial OBS or IR were included. The primary outcome was need for operation. Secondary outcomes included liver-related complications (LRCs) and mortality. Results: From 59 patients, 23 (39.0%) were managed with OBS and 36 (61.0%) with IR. 75% of IR patients underwent angioembolization, whereas 13% of OBS patients underwent any IR, all undergoing angioembolization. IR patients had an increased rate of operation (13.9% vs. 0%, p = 0.049), but no difference in LRCs (44.4% vs. 43.5%) or mortality (5.6% vs. 8.7%) versus OBS patients (both p > 0.05). Conclusion: Over 60% of patients were managed with IR initially. IR patients had an increased rate of operation yet similar rates of LRCs and mortality, suggesting initial OBS reasonable in appropriately selected HGLI + Extrav patients.
Repository Citation
Aryan, N.,
Grigorian, A.,
Tay-Lasso, E.,
Cripps, M.,
Carmichael, H.,
McIntyre, R.,
Urban, S.,
Velopulos, C.,
Cothren Burlew, C.,
Ballow, S.,
Dirks, R. C.,
LaRiccia, A.,
Farrell, M. S.,
Stein, D. M.,
Truitt, M. S.,
Grossman Verner, H. M.,
Mentzer, C. J.,
Mack, T. J.,
Ball, C. G.,
Mukherjee, K.,
Mladenov, G.,
Haase, D. J.,
Abdou, H.,
Schroeppel, T. J.,
Rodriquez, J.,
Bala, M.,
Keric, N.,
Crigger, M.,
Dhillon, N. K.,
Ley, E. J.,
Egodage, T.,
Williamson, J.,
Cardenas, T. C.,
Eugene, V.,
Patel, K.,
Costello, K.,
Bonne, S.,
Elgammal, F. S.,
Dorlac, W.,
Pederson, C.,
Werner, N. L.,
Haan, J. M.,
Lightwine, K.,
Semon, G.,
Spoor, K.,
Harmon, L. A.,
Samuels, J. M.,
Spalding, M. C.,
& Nahmias, J.
(2024). High-Grade Liver Injuries With Contrast Extravasation Managed Initially With Interventional Radiology Versus Observation: A Secondary Analysis of a WTA Multicenter Study. American Journal of Surgery, 234, 105-111.
https://corescholar.libraries.wright.edu/surg/845
DOI
10.1016/j.amjsurg.2024.03.018
Comments
This work is licensed under CC BY 4.0
