CONTROL OF HEPATIC BLEEDING BY BALLOON TAMPONADE: AN EXPERIMENTAL STUDY

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HOJATI H.; SYVANI E.; KAZEMI KOROUSH

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Journal: JOURNAL OF MEDICAL RESEARCH (JMR) Year:2003 | Volume:1 | Issue:4 Page(s): 17-24

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Title

CONTROL OF HEPATIC BLEEDING BY BALLOON TAMPONADE: AN EXPERIMENTAL STUDY

Author(s)

HOJATI H. | SYVANI E. | KAZEMI KOROUSH | Issue Writer Certificate

Keywords

HEPATIC TRAUMAQ4

BLUNT AND PENETRATING TRAUMAQ4

BALLOON TAMPONADEQ4

Abstract

Background: The overall mortality in civilians sustaining hepatic injuries remains in the vicinity of 10%. As 70-90 percent of all hepatic injuries are minor, complex hepatic injuries remain formidable challenges even for the most experienced trauma surgeons. Until recently, these complex hepatic injuries were associated with mortality rates often in excess of 50%. However, in the last decade a number of major changes have occurred in the way complex hepatic injuries are managed. These changing approaches have been responsible for reducing the mortality of grade III and IV hepatic injuries to less than 10%. Materials and Methods: This study was performed on 20 white young rabbits with a mean weight of 2.1 kilograms. The rabbits were randomly divided into two equal groups: A and B. Under general anesthesia with intra-venous diazepam, intra-peritoneal ketamine and ether inhalation, a midline laparatomy was performed. Liver was evaluated and a 22 cm wound was made on the right lobe. In group A, control of bleeding was done by wrapping a penrose drain on the injured site while it was filled with normal saline. Two limbs of the penrose drain were exteriorized from the lateral abdominal wall and a 3- way foly catheter was connected to one limb to measure the pressure and fill the penrose cavity. Intra-peritoneal pressure (IPP) was measured by an intra-vesicular catheter. In group B, control of hepatic bleeding was performed by perihepatic gauze packing. In both groups IPP, duration of operation, bile leakage and infection rate were recorded. Results: Operation time was 20 minutes and 40 minutes in groups A and B, respectively. Post-operation time needed for full control of hepatic bleeding was 24-36 hours and 72-96 hours in group A and B, respectively. In group A, there was no raised intra-abdominal pressure while an increase was observed in 20 percent of group B. Spontaneous displacement of penrose balloon was seen in 10 percent of group A, while no collection and bile leakage was detected. In group B, 30 percent bile leakage and subhepatic collection was seen. Mortality in group A and B was, zero and 30 percent, respectively. Severe postoperation perihepatic adhesion band was detected only in groupB (30 percent). Histopathologic study of group A showed no reaction to the penrose drain. Conclusion: This study showed that perihepatic balloon is effective in the control of hepatic bleeding due to trauma. Control of intra-balloonic pressure from outside and its removal without need for re-laparatomy eliminates most post-operation complications of peri-hepatic packing such as sepsis, increase of intra-abdominal pressure and subsequent abdominal compartment syndrome. Perihepatic BALLOON TAMPONADE is an easy, safe, effective, and rapid method for control of hepatic bleeding due to trauma.

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APA: Copy

HOJATI, H., SYVANI, E., & KAZEMI, KOROUSH. (2003). CONTROL OF HEPATIC BLEEDING BY BALLOON TAMPONADE: AN EXPERIMENTAL STUDY. JOURNAL OF MEDICAL RESEARCH (JMR), 1(4), 17-24. SID. https://sid.ir/paper/105786/en

Vancouver: Copy

HOJATI H., SYVANI E., KAZEMI KOROUSH. CONTROL OF HEPATIC BLEEDING BY BALLOON TAMPONADE: AN EXPERIMENTAL STUDY. JOURNAL OF MEDICAL RESEARCH (JMR)[Internet]. 2003;1(4):17-24. Available from: https://sid.ir/paper/105786/en

IEEE: Copy

H. HOJATI, E. SYVANI, and KOROUSH KAZEMI, “CONTROL OF HEPATIC BLEEDING BY BALLOON TAMPONADE: AN EXPERIMENTAL STUDY,” JOURNAL OF MEDICAL RESEARCH (JMR), vol. 1, no. 4, pp. 17–24, 2003, [Online]. Available: https://sid.ir/paper/105786/en

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