Operative Management of Adult Blunt Hepatic Trauma
Annotation for Point D
Bleeding not controlled by packing alone suggests a complex hepatic injury. An orderly assessment of the injury should be undertaken.37,38 The first step entails a Pringle maneuver, with placement of a vascular clamp on the porta hepatis to control portal vein and hepatic artery bleeding. If not already performed, takedown of the falciform, coronary, and triangular ligaments should be undertaken.