Delayed versus early hepatic resection among patients with severe traumatic liver injuries undergoing damage control laparotomy

Introduction: We aimed to assess the effect of time to hepatic resection on the outcomes of patients with high-grade liver injuries who underwent damage control laparotomy (DCL). Methods: This is a 4-year (2017–2020) analysis of the ACS-TQIP. Adult trauma patients with severe liver injuries (AAST-OIS grade ​≥ ​III) who underwent DCL and hepatic resection were included. We excluded patients with early mortality (<24 ​h). Patients were stratified into those who received hepatic resection within the initial operation (Early) and take-back operation (Delayed). Results: Of 914 patients identified, 29% had a delayed hepatic resection. On multivariable regression analyses, although delayed resection was not associated with mortality (aOR:1.060,95%CI[0.57–1.97],p ​= ​0.854), it was associated with higher complications (aOR:1.842,95%CI[1.38–2.46],p ​< ​0.001), and longer hospital (β: +0.129, 95%CI[0.04–0.22],p ​= ​0.005) and ICU (β:+0.198,95%CI[0.14–0.25],p ​< ​0.001) LOS, compared to the early resection. Conclusion: Delayed hepatic resection was associated with higher adjusted odds of major complications and longer hospital and ICU LOS, however, no difference in mortality, compared to early resection.