Major hepatectomy for complex liver trauma

The liver is the most frequently injured intraperitoneal organ, despite its relatively protectedlocation. The liver consisting of a relatively fragile parenchyma contained within the Glisson capsule, whichis thin and does not provide it with great protection. The management of hepatic trauma has undergonea paradigm shift over the past several decades with significant improvement in outcomes. Shifting frommandatory operation to selective nonoperative treatment, and, presently, to nonoperative treatmentwith selective operation. Operative management emphasizes packing, damage control, and utilization ofinterventional radiology, such as angiography and embolization. Because of the high morbidity and mortality,liver resection seems to have a minimal role in the management of hepatic injury in many reports, but in aspecialized referral center, like our institute, surgical treatment becomes, in many cases, the only life-savingtreatment. Innovations in liver transplant surgery, living liver donation, and the growth of specialized liversurgery teams have changed the way that surgeons and hepatic resection are done.