Clinical outcomes of primary arterial embolization in severe hepatic trauma: A systematic review.

Authors:
J Kumar
J Kumar
Indian Institute of Technology Bombay (IIT)
India
M Podda
M Podda
University of Milan
Italy

Diagn Interv Imaging 2019 Feb 13;100(2):65-75. Epub 2018 Dec 13.

General, Emergency and Robotic Surgery Unit, San Francesco Hospital, 08100 Nuoro NU, Italy.

Purpose: This purpose of this systematic review was to determine the safety and efficacy of arterial embolization as the primary treatment for grade III-V liver trauma, excluding the postoperative use of arterial embolization.

Material And Methods: A total of 24 studies published between January 2000 and June 2018 qualified for inclusion in this study. Four of them were prospective studies and 20 were retrospective. A total of 3855 patients (mean age, 33.5 years; range: 22-52.5 years) were treated non-operatively and 659 patients (659/3855; 17.09%) with hepatic hemorrhage underwent primary arterial embolization from 2000 to 2017. Indication for arterial embolization was a contrast blush visible on computed tomography in hemodynamically stable patient in all studies.

Results: The arterial embolization success rate ranged from 80% to 97%. The most commonly reported complication was bile leak, with an incidence of 5.7%. Nineteen bilomas (2.8%) were reported in five studies with a range between 4% and 45%. Hepatic ischemia was reported in eight studies, with a mean incidence of 8.6%.

Conclusion: Primary arterial embolization has a high success rate in patients with hepatic trauma. Complications, including biloma and hepatic ischemia, have acceptable rates in the context of a minimally-invasive procedure that allows stabilization of life-threatening, complex liver injuries.

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Source
https://linkinghub.elsevier.com/retrieve/pii/S22115684183024
Publisher Site
http://dx.doi.org/10.1016/j.diii.2018.10.004DOI Listing

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February 2019
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