Systematic Review of the Management of Retro-Hepatic Inferior Vena Cava Injuries

Figures & data

Figure 1 Prisma Diagram outlining research process.

Table 1 Studies Included in Critical Appraisal and Literature Review

Reference Number	Name	Year	Country	n	Mortality
^Citation9	Current approach to liver traumas.	2017	Turkey	14	100%
^Citation10	Severe Blunt Hepatic Trauma in Polytrauma Patient - Management and Outcome.	2015	Serbia	10	90%
^Citation11	Management of severe blunt liver injuries by applying the damage control strategies with packing-oriented surgery: experiences at a single institution in Korea.	2015	Korea	23	39%
^Citation12	Evaluation of liver injury in a tertiary hospital: a retrospective study.	2014	Turkey	1	100%
^Citation13	Management and treatment of liver injury in children.	2014	Turkey	1	100%
^Citation14	Complications of high grade liver injuries: management and outcome with focus on bile leaks.	2012	Israel	16	69%
^Citation15	Management of liver injuries: predictors for the need of operation and damage control surgery.	2013	Thailand	13	62%
^Citation16	Non-operative management of isolated liver trauma.	2014	China	6	Indeterminate (estimated 33%)
^Citation17	Management of liver trauma in Kuwait.	2013	Kuwait	11	18%
^Citation18	Retrospective Evaluation of Magnitude, Severity and Outcome of Traumatic Hepatobiliary Injury at a Level-I Trauma Center in India.	2015	India	14	50%
^Citation19	Surgical management and outcome of blunt major liver injuries: experience of damage control laparotomy with perihepatic packing in one trauma centre.	2013	Taiwan	14	79%
^Citation20	Early right hepatectomy for severe liver trauma: a case report.	2015	Italy	1	0%
^Citation21	Improved outcomes in the non-operative management of liver injuries.	2011	Netherlands	4	Indeterminate (estimated 50%)
^Citation22	Complications of nonoperative management of high-grade blunt hepatic injuries.	2005	USA	8	13%
^Citation23	Selective management of blunt hepatic injuries including nonoperative management is a safe and effective strategy.	2005	USA	19	63%
^Citation24	Major hepatic necrosis: a common complication after angioembolization for treatment of high-grade liver injuries.	2009	USA	80	53%
^Citation25	Blunt liver injury: from non-operative management to liver transplantation.	2000	Italy	6	17%
^Citation26	Changes in the management of liver trauma leading to reduced mortality: 15-year experience in a major trauma centre.	2013	Australia	31	42%
^Citation27	Angiographic embolization for liver injuries: low mortality, high morbidity.	2003	USA	3	67%
^Citation28	Severe blunt hepatic trauma in children.	1998	USA	25	36%
^Citation29	Hepatic trauma: analysis of the treatment with intrahepatic balloon in a university hospital of Curitiba.	2009	Brazil	2	50%
^Citation30	Operative and nonoperative management of blunt hepatic trauma in adults: a single-center report.	2004	Greece	3	100%
^Citation31	Place of arterial embolization in severe blunt hepatic trauma: a multidisciplinary approach.	2007	France	3	33%
^Citation32	Approach to the management of complex hepatic injuries.	1997	USA	9	22%
^Citation33	Outcome of children with blunt liver or spleen injuries: Experience from a single institution in Korea.	2016	Korea	2	50%

Table 2 Operative Interventions Identified in the Literature

Operative Intervention	Number of Studies Reporting Technique
Packing	13(9)(10)(11)(12)(15)(16)(18)(19) (25)(26)(31)(32) (33)
Direct suture/hepatorraphy	7(10)(11)(19)(21)(25)(32)(33)
Selective hepatic artery ligation	2(11),(19)
Fibrin sealants	1(11)
Resection	8(9)(10)(13)(15)(25)(26) (31) (33)
Non-operative management	7(14)(16)(17)(22)(23)(25)(26)
Damage control surgery	2(10)(18)
Hepatectomy	6(9)(19)(20)(25)(30)(32)
Angioembolization	5 (21)(24)(27)(31)(32)
Intrahepatic balloon	1(29)

Figure 2 Proposed algorithm for RHIVC Injuries.

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