Die aktuelle Entwicklung der Behandlung eines Lebertraumas hat bewiesen, daβ groβzügige Leberresektionen selbst bei schweren Läsionen zugunsten einfacherer Verfahren wie der perihepatischen Tamponade vermieden werden können. Dieses Verhalten ist nicht als ein Miβerfolg der Chirurgie zu betrachten, sondern als ein strategischer Rückzug bei einer äuβerst kritischen Notfallsituation. Eine optimal programmierte sekundäre Operation, ausgeführt durch in der Leberchirurgie erfahrene Operateure, kann nur zur Verbesserung der Prognose schwerer Lebertraumen führen. Das Konzept einer konservativen nichtoperativen Therapie entspricht dank moderner Untersuchungsverfahren einem therapeutischen Fortschritt unter der strikten Voraussetzung, daβ die Durchfiihrung nur unter chirurgischen Intensivbedingungen vertretbar ist.

Keywords:
Lebertrauma, -operative Therapie, -konservative Therapie
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© 1995 S. Karger AG, Basel
1995
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