Abstract: Objective To analyze the factors influencing complications after damage control surgery in patients with traumatic hepatic rupture. Methods The clinical data of 92 patients with traumatic hepatic rupture who underwent damage control surgery in Dongnan Hospital Affiliated to Xiamen University from January 2019 to December 2023 were retrospectively analyzed.They were divided into complication group (n=22) and non-complication group (n=70) according to whether postoperative complications occurred.Univariate and multivariate logistic regression analyses were performed to identify factors associated with complications after damage control surgery. According to the results of multifactor analysis, a receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of the multivariate logistic regression model for postoperative complications. Results All 92 patients with traumatic liver rupture underwent damage control surgery. Postoperative complications occurred in 22 cases (23.91%), including bile leakage in 12 cases, infection in 5 cases, hemorrhage in 3 cases and multiple organ failure in 2 cases. According to the AAST liver injury grading system, 17 patients had grade Ⅰ injuries, 10 had grade Ⅱ injuries, 34 had grade Ⅲ injuries, 25 had grade Ⅳ injuries, 6 had grade Ⅴ injuries, and none had grade Ⅵ injuries.The proportion of patients with an interval from injury to damage control surgery of ≥4 h, shock, an AAST liver injury grade of Ⅲ or higher, bile leakage after damage control surgery, postoperative infection control, bile duct injury and other organ injury in complication group was higher than that in non-complication group (P<0.05). Multivariate analysis showed that an interval from injury to damage control surgery of ≥4 h (OR:7.851, 95%CI:1.360～45.337), bile leakage after damage control surgery (OR:13.780, 95%CI: 2.322～81.781), control of postoperative infection (OR:5.634, 95%CI:1.013～31.341), combined with bile duct injury (OR: 6.277, 95%CI: 1.349～29.195) were risk factors for complications after damage control surgery for traumatic hepatic rupture.The ROC curve was drawn according to the multivariate logistic regression model. Area under the curve (AUC) was 0.924, sensitivity was 0.914, specificity was 0.727, 95%CI was 0.871～0.978, P<0.001. Conclusion Patients with traumatic liver rupture still have a high incidence of complications after receiving damage control surgery. A time from injury to damage control surgery of ≥4 h, bile leakage after damage control surgery, infection after damage control surgery, and concomitant bile duct injury are risk factors for complications.

Key words: Traumatic hepatic rupture, Bile leakage, Bleeding, Infection, Complications, Damage control surgery