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What is Pringle Maneuver (Total Inflow Occlusion)?
- Total clamping of the hepatic pedicle, by placing an atraumatic clamp across the foramen of WinslowQ.
- • Appropriate-sized vascular clamp or loop snare easily controls hemorrhage from either the portal vein or the hepatic arteriesQ.
- • Inflow occlusion durations of up to 30 minutes can be tolerated safely in cirrhotic livers and possibly up to 60 minutes in early disease. • If prolonged occlusion is required, intermittent clamping can be used with repeated clampings of 10-20 minutes duration, each followed by 5 minutes declamping.
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What is Trisegmentectomy?
- Right trisegmentectomy or extended right hepatectomy: Complete resection of segment IV with the right liver (removal of segment IV, V, VI, VII, VIII) Q.
- Left trisegmentectomy or extended left hepatectomy: Complete resection of segments V and VIII with the left liver (removal of segment II, III, IV, V, VIII)
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What is duration of Liver Regeneration?
Following resection of 2/3rd of the liver, regeneration is complete within 5-6 months.
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MC organ injured in blunt abdominal trauma?
Spleen > liverQ
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Most common organ injured in penetrating abdominal injuries?
small bowel (38%) > colon (31%)Q > , liver (28%)
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Most common segments involved in liver injury?
- 6, 7 and 8 of the liverQ.
- Lver injury bleeding is venous Q; and therefore low pressure, tamponade is readily performed
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Conservative criteria for non-operative management in lier injury?
- Hemodynamically stable patientQ
- No peritoneal signs on examinationQ
- Absence of other major injuriesQ
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MC complication of severe liver injury in patients who undergo operationQ?
Liver parenchymal necrosis
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MC complication of non-operative management of liver injury?
Rebleeding
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Management of Deep Liver Laceration?
Opening the liver wound and directly approaching the bleeding vessel, a procedure known as tractotomyQ.
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Management of Penetrating Liver Tracts?
Tractotomy or tamponade using a balloon catheterQ
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Management of Injuries in the vicinity of retrohepatic IVC?
Packing alone, without operative exploration Q
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Management of Retrohepatic IVC Injury?
Atriocaval shunt (Shrock shunt)Q
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