High-grade liver injuries with contrast extravasation managed initially with interventional radiology versus observation: A secondary analysis of a WTA multicenter study.
Am J Surg
; 234: 105-111, 2024 Aug.
Article
em En
| MEDLINE
| ID: mdl-38553335
ABSTRACT
BACKGROUND:
High-grade liver injuries with extravasation (HGLI â+ âExtrav) 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 â+ âExtrav. Therefore, we evaluated the management of HGLI â+ âExtrav patients, hypothesizing IR patients will have decreased rates of operation and mortality.METHODS:
HGLI â+ âExtrav 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 â= â0.049), but no difference in LRCs (44.4% vs. 43.5%) or mortality (5.6% vs. 8.7%) versus OBS patients (both p â> â0.05).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 â+ âExtrav patients.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Embolização Terapêutica
/
Extravasamento de Materiais Terapêuticos e Diagnósticos
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Fígado
Limite:
Adult
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Aged
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Am J Surg
Ano de publicação:
2024
Tipo de documento:
Article