| Abstract Number: 59 |
| Title: LAPAROSCOPIC TREATMENT SECONDARY TO NONOPERATIVE TREATMENT OF BLUNT HEPATIC AND SPLENIC TRAUMA. |
| Authors: ARVIEUX C., CARDIN N., USAI A., BOCQUERAZ F., BROUX C. , THONY F., OUGHRISS M., DELANNOY P., RISSE O., LETOUBLON C. |
| Abstract: Aim of the study: Nonoperative management of liver and spleen trauma in hemodynamically stable patients with blunt abdominal trauma has become the standard of care in most cases (1) but the failure rates still range from 5% to 20% (2). In such cases, abdominal compartment syndrome, persistence of bleeding and an injury of hollow viscus are the main cause of exploratory laparotomy. We apply in a level I trauma center exploratory laparoscopy and, if feasible, the laparoscopic treatment of the lesions.
Patients and methods: From January 1, 2003 through April 30, non operative treatment was required for 149 hemodynamically stable patients with suspicious abdominal injuries. During the study period, 56 abdominal explorations were performed. 53 patients underwent laparotomies and 3 hemodynamically stable patients underwent laparoscopy by a surgeon skilled in laparoscopy (5%).
Results: clinical data and laparoscopic evaluation of the 3 patients treated are summarized in the following table:
Discussion/conclusion: those preliminary results suggest that on hemodynamically stable patients, the laparoscopic management of spleen and liver blunt trauma is a safe and accurate procedure that enables laparoscopic intervention (2,3).
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