Comparative Study of Nonoperative- and Operative Methods for the Management of Liver Gunshot Injury

Abstract

Background and Aim: Gunshot injury is a kind of penetrating injury, which makes a challenge for a surgeon. Liver is the most common injured abdominal organ.

Patients and Methods: We prospectively analyzed 104 Patients with liver gunshot injury. Between August 2012 and December 2013.

Results:  66% of patients have GI-III liver gunshot injury and 34% had grade IV and V.

88% of patients underwent a Laparotomy,  and 12%  were treated  non- operatively. 

85% of surgical patients were managed by tamponade packing or parenchymal suture. There were no difference in complications between the two procedures. Bile leak occurred by 23% of operative patients and by 9% of non-operative patients. Mortality rate was 9% in operative patients. Lethal triad was the commonest cause of death.

No Patient died by conservative therapy (non-operative management).

Conclusion: The determined use of non-operative management of the liver gunshot  injury contributed in specific cases in decreasing the incidence of unnecessary laparotomies as well as overall morbidity and mortality.

Keywords: Liver, gunshot, nonoperative and operative management, perihepatic packing, bile leak, lethal triad