Clinical Analysis Of The Treatment Of Grade Ⅲ And Ⅳ Right Posterior Liver Trauma With Left Semiprone Position Under Laparoscopy

Objective: to analyze the feasibility,safety and efficacy of the treatment of grade III and IV right posterior lobe liver trauma with left semiprone position under laparoscopy.Methods: The clinical data of patients with grade III and IV right posterior lobe liver trauma who underwent surgical treatment at the Affiliated Hospital of Youjiang Medical University for Nationalities from Jan.2013 to Dec.2019 were analyzed retrospectively.They were divided into laparoscopic group and open group.The following data were compared.Baseline data: age,gender,systolic pressure,diastolic pressure,heart rate.Injury details: time of injury,mechanisms of injury,concomitant injuries,degree of liver injury.Intraoperative details: abdominal effusion,cases of blood transfusion,repair methods,operation time,intraoperative blood loss.Postoperative details: fasting time,drainage tube removal time,hospital stay,complications.Laboratory examination: red blood cells,hemoglobin,white blood cells,neutrophils,alanine aminotransferase,aspartate aminotransferase on admission and the first day after operation.Results: There were 15 patients in the laparoscopic group and 16 patients in the open group.There was no significant difference in baseline data and injury details between the two groups(P > 0.05).All patients were successfully completed the operation.There was no significant difference in the amount of hemoperitoneum,the number of blood transfusions and the repair methods(P > 0.05).There were significant differences in operation time,intraoperative blood loss,postoperative fasting time,drainage tube removal time and hospital stay,and the former is better than the latter(P < 0.05).There were significant differences in white blood cells,neutrophils and alanine aminotransferase on the first day after operation(P< 0.05).Conclusion: It is feasible and safe for the treatment of hemodynamically stable patients with right posterior liver trauma with left semiprone position under laparoscopy.Which has the advantages of better exposure,convenient repair,less secondary injury and shorter hospital stay.