The use of low-invasive surgical procedures in the treatment of gunshot wounds of the liver.
The problem of diagnostics and stage surgical treatment of a combat trauma of the abdomen with liver damage is actual in conditions of increasing specific gravity of liver damage, accompanied by its severe functional insufficiency. The aim of the study was to improve the results of surgical treatmen...
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| Format: | Article |
| Language: | English |
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Dnipro State Medical University
2018-12-01
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| Series: | Medičnì Perspektivi |
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| Online Access: | http://journals.uran.ua/index.php/2307-0404/article/view/145710 |
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| author | I. P. Khomenko O. S. Herasymenko Ya. I. Haida K. R. Muradian R. B. Yenin |
| author_facet | I. P. Khomenko O. S. Herasymenko Ya. I. Haida K. R. Muradian R. B. Yenin |
| author_sort | I. P. Khomenko |
| collection | DOAJ |
| description | The problem of diagnostics and stage surgical treatment of a combat trauma of the abdomen with liver damage is actual in conditions of increasing specific gravity of liver damage, accompanied by its severe functional insufficiency. The aim of the study was to improve the results of surgical treatment of gunshot wounds of the liver using minimally invasive surgical techniques. The analysis of surgical treatment of 23 men aged 19 to 49 years with gunshot liver damage at II-IV levels of medical care was carried out. Shock of I st. was observed in 5 (21.7%), II st. - in 8 (34,8%), III st. - 9 wounded (39.2%), IV st. - 1 wounded (4.3%), admitted in an agonizing condition. At the second level of medical care, 12 wounded underwent laparoscopic operations (52.1%). 11 wounded underwewnt laparotomy (47.9%) with the use of mechanical, physical and chemical methods of bleeding stopping. In 17 wounded (73.9%), concomitant lesions of other organs of the abdominal cavity and retroperitoneal space (stomach, small and large intestine, kidneys, spleen) were observed. Correction of concomitant damages was carried out according to generally accepted methods. At the IV level of medical care, three wounded (12.9%) underwent puncture and drainage of intrahepatic abscesses using ultrasound navigation. Ultrasound examination allowed to determine the degree of liver damage, localization of a foreign body and safe access to its removal. In the structure of gunshot wounds of the abdomen, liver damage makes up 19.2% and the most often is observed in combined shrapnel wounds. In 30.4% of cases of gunshot liver damages, the condition of the wounded is regarded as severe and critical, which requires immediate surgical and resuscitative measures. The use of minimally invasive techniques (video laparoscopy, interventional sonography) in the surgical treatment of gunshot liver injuries can improve results and avoid unreasonable laparotomies. |
| format | Article |
| id | doaj-art-82d35e5cc4024391bbbcb353094128bc |
| institution | OA Journals |
| issn | 2307-0404 |
| language | English |
| publishDate | 2018-12-01 |
| publisher | Dnipro State Medical University |
| record_format | Article |
| series | Medičnì Perspektivi |
| spelling | doaj-art-82d35e5cc4024391bbbcb353094128bc2025-08-20T02:08:35ZengDnipro State Medical UniversityMedičnì Perspektivi2307-04042018-12-01234(part1)11111510.26641/2307-0404.2018.4(part1).145710145710The use of low-invasive surgical procedures in the treatment of gunshot wounds of the liver.I. P. KhomenkoO. S. HerasymenkoYa. I. HaidaK. R. MuradianR. B. YeninThe problem of diagnostics and stage surgical treatment of a combat trauma of the abdomen with liver damage is actual in conditions of increasing specific gravity of liver damage, accompanied by its severe functional insufficiency. The aim of the study was to improve the results of surgical treatment of gunshot wounds of the liver using minimally invasive surgical techniques. The analysis of surgical treatment of 23 men aged 19 to 49 years with gunshot liver damage at II-IV levels of medical care was carried out. Shock of I st. was observed in 5 (21.7%), II st. - in 8 (34,8%), III st. - 9 wounded (39.2%), IV st. - 1 wounded (4.3%), admitted in an agonizing condition. At the second level of medical care, 12 wounded underwent laparoscopic operations (52.1%). 11 wounded underwewnt laparotomy (47.9%) with the use of mechanical, physical and chemical methods of bleeding stopping. In 17 wounded (73.9%), concomitant lesions of other organs of the abdominal cavity and retroperitoneal space (stomach, small and large intestine, kidneys, spleen) were observed. Correction of concomitant damages was carried out according to generally accepted methods. At the IV level of medical care, three wounded (12.9%) underwent puncture and drainage of intrahepatic abscesses using ultrasound navigation. Ultrasound examination allowed to determine the degree of liver damage, localization of a foreign body and safe access to its removal. In the structure of gunshot wounds of the abdomen, liver damage makes up 19.2% and the most often is observed in combined shrapnel wounds. In 30.4% of cases of gunshot liver damages, the condition of the wounded is regarded as severe and critical, which requires immediate surgical and resuscitative measures. The use of minimally invasive techniques (video laparoscopy, interventional sonography) in the surgical treatment of gunshot liver injuries can improve results and avoid unreasonable laparotomies.http://journals.uran.ua/index.php/2307-0404/article/view/145710combat trauma to the abdomenliver damageultrasound diagnosislaparoscopy |
| spellingShingle | I. P. Khomenko O. S. Herasymenko Ya. I. Haida K. R. Muradian R. B. Yenin The use of low-invasive surgical procedures in the treatment of gunshot wounds of the liver. Medičnì Perspektivi combat trauma to the abdomen liver damage ultrasound diagnosis laparoscopy |
| title | The use of low-invasive surgical procedures in the treatment of gunshot wounds of the liver. |
| title_full | The use of low-invasive surgical procedures in the treatment of gunshot wounds of the liver. |
| title_fullStr | The use of low-invasive surgical procedures in the treatment of gunshot wounds of the liver. |
| title_full_unstemmed | The use of low-invasive surgical procedures in the treatment of gunshot wounds of the liver. |
| title_short | The use of low-invasive surgical procedures in the treatment of gunshot wounds of the liver. |
| title_sort | use of low invasive surgical procedures in the treatment of gunshot wounds of the liver |
| topic | combat trauma to the abdomen liver damage ultrasound diagnosis laparoscopy |
| url | http://journals.uran.ua/index.php/2307-0404/article/view/145710 |
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