**11. Conclusion**

The liver is the second most common affected organ in abdominal trauma and therefore has a prominent role in all the abdominal traumas. During the past decade, the management presented a significant evolution especially with the growth of interventional radiology. Procedures such as arteriography and arterial embolization helped to manage once difficult lesions with poor prognosis. Nevertheless, when it is possible, the nonoperative management should be preferred since it presents less morbidity.

Hepatic lesions classified as grade IV are a cause for anguish and anxiety for the surgeons, since they present a higher morbidity and mortality. The first concern in severe liver trauma should be the patient stabilization, which can be done through damage control surgery, which consists of executing the crucial and strategically ordered steps (shortened surgery, correction of physiological measurements in intensive care and proposed reoperation) to reduce operational time, correct a loss of death (medicated by acidosis, hypothermia, and coagulopathy), and improve the patient's long-term prognosis.

In the context of trauma, control damage surgery appears as an alternative for severely injured patients, who have multiple injuries to the abdominal viscera.

After clinical stabilization in an intensive care unit, the patient will be reoperated, and less severe injuries will be corrected, with the patient's gradual recovery after correcting the lethal triad.

In the same perspective, this chapter reviewed liver trauma centered on damage control surgery, providing the main content related to the topic, from its causes, trauma mechanism, classification, bibliographic review, therapeutic options, and current statistics to prognosis and the role of damage control surgery in this context. Thus, it is expected that at the end of the chapter, the reader will be able to organize the main topics related to liver trauma and consider making difficult decisions in practice in trauma hospital, always seeking the best prognosis for patients.
