To investigate the feasibility and clinical effect of non-surgical treatment of patients with liver trauma.

Clinical data of 68 liver trauma patients receiving non-surgical treatment in three centers including Department of General Surgery in Dachang Hospital of Shanghai, Department Ⅱ of General Surgery in Tongji Affiliated Hospital of Tongji University and Department Ⅰ of General Surgery, in Baoshan Campus of Huashan Affiliated Hospital, Fudan University, from January 2001 to December 2011, were analyzed retrospectively. Local ethical committee approval had been received and that the informed consent of all participating subjects was obtained. Fifty-seven patients were males and 11 were females. The age of patients were from 7 to 65 years old with the mean age of 34 years old. According to the liver trauma grading of American Association for Surgery of Trauma(ASST), 35 patients (51%) were grade Ⅰ, 29(43%) were grade Ⅱ and 4(6%) were grade Ⅲ. All patients were given non-surgical treatment including strict bed rest, fasting, gastrointestinal decompression, fluid infusion, blood transfusion and so on. The water electrolyte balance and hemodynamic stability were carefully monitored and maintained. Hemostatics and antibiotics were also applied. The blood pressure, pulse, heart rate, changes of hemoglobin and hematocrit and abdominal symptoms were observed. Ultrasonic examination or computed tomography (CT) as well as appropriate treatment of associated injuries were given to all patients regularly or under necessary circumstances. The related complications and mortality of those patients, who were converted to open surgery, were observed. All patients were followed up after operation. The recovering of liver trauma was monitored by ultrasonography.

Sixty-six patients including 4 cases with grade Ⅲ of liver trauma recovered successfully with 97% successful rate. The other 2 cases underwent operation and recovered well. No complications and death occurred. Fifty-five patients were followed up for an average time of 6 months. The ultrasonography showed that the wound of the injured liver recovered and the hematoma was absorbed.

The non-surgical treatment for liver trauma is feasible and effective with carefully monitoring, close observation, effective treatment as well as thorough understanding of indications for surgery.