The Role of Angioembolization in Liver Trauma: the 10-Year Retrospective Experience of a Level One Trauma Center

Abstract

The role of angioembolization in managing hemodynamically stable patients with liver injury has obviated the need for surgery. Although mortality and morbidity rates after the adoption of this technique have decreased, this procedure is not devoid of complications. This study assesses the impact of this procedure and its associated complications. We performed a case series analysis of patients with hepatic trauma in a level one trauma center over 10 years (2008–2017). Data were collected from hospital records of patients with liver injury and analyzed according to demographics, injury type, management strategy, procedure time, efficacy, complications of embolization, and outcome. We included all patients who underwent angioembolization. Patients who underwent surgery only or had incomplete records were excluded. Of 366 patients with liver trauma, eighteen were managed with angioembolization. Of which, thirteen had grade IV injury or higher, while five had grade II or III. Twelve patients had blunt liver trauma. Six patients were initially managed by laparotomy followed by angioembolization. The most common embolized artery was the right hepatic artery (eleven patients). Nine patients had at least one complication after the procedure. The liver collection was the most common complication (seven patients). There was one hepatic complication-related death. Morbidity was more common in patients who underwent exploratory laparotomy before angioembolization compared to angioembolization alone. Those who had a laparotomy before the angioembolization may have a higher complication rate.

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Data Availability

The data were archived as required by GCP guidelines and the IRB.

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Affiliations

Authors

Contributions

Ashraf Imam: Study design conception, data acquisition, interpretation and analysis, drafting of the article, critical review for intellectual content, final drafting, and approval of the manuscript and reviewing the manuscript

Gabriel Szydlo: Data collection, drafting of the manuscript, and approval of the manuscript

Sadi Abukhalaf: Data collection, drafting of the manuscript, and approval of the manuscript

Bala Miklosh: Literature search, practical work, operative work, data acquisition, manuscript writing, and approval of the manuscript

Asaf Kidar: Literature search, practical work, operative work, data acquisition, manuscript writing, and approval of the manuscript

Samir Abu-Gazala: Literature search, practical work, operative work, data acquisition, manuscript writing, and approval of the manuscript

Gideon Zamir: Literature search, practical work, operative work, data acquisition, manuscript writing, and approval of the manuscript

Allan Bloom: Literature search, practical work, operative work, data acquisition, manuscript writing, and approval of the manuscript

Harbi Khalayleh: Literature search, practical work, operative work, data acquisition, manuscript writing, and approval of the manuscript

Alon J. Pikarsky: Literature search, practical work, operative work, data acquisition, manuscript writing, and approval of the manuscript

Abed Khalaileh: Study design conception, critical review for intellectual content, and final approval of the manuscript

All of the authors read, reviewed, and approved the final version of the manuscript.

Corresponding author

Correspondence to Abed Khalaileh.

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The authors declare that they have no conflicts of interest.

Ethical Approval

This study was approved by the Ethics Committee of Hadassah-Hebrew University Medical Center (Number: 0314-19-HMO).

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The IRB waived the need for informed consent for this retrospective study.

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Imam, A., Szydlo, G., Abukhalaf, S. et al. The Role of Angioembolization in Liver Trauma: the 10-Year Retrospective Experience of a Level One Trauma Center. Indian J Surg (2021). https://doi.org/10.1007/s12262-021-02726-0

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Keywords

  • Hepatic trauma
  • Liver angiography
  • Angioembolization
  • Complications