Operative management for complex hepatic injuries  WANG Dong, ZHU Ji-ye. Department of Hepatobiliary Surgery，Peking University People’s Hospital，Beijing100044，China.
Corresponding author: ZHU Ji-ye, E-mail: gandanwk@vip.sina.com
Abstract    Complex liver injuries are severe damages of liver parenchyma with or without rupture of important blood vessels. The mortality of complex liver injuries is high and it is hard to treat. Non-operative management (NOM) of hemodynamically stable patients has become the standard of care, while operation should be applied to those hemodynamically unstable patients and other organs involved. Irregular hepatectomy, direct repair of vessels, perihepatic packing are common blood control methods, while damage control surgery (DCS) is recommended in those with hypothermia, metabolic acidosis and coagulation disorders. Reduction of mortality might be found if combination therapy of hepatic arterial embolization and DCS was applied to them.