An analysis of 77 cases of pancreatic injuries at a level one trauma center: Outcomes of conservative and surgical treatments.
Adult
Conservative management
Pancreas
Pediatric
Trauma
Journal
Annals of hepato-biliary-pancreatic surgery
ISSN: 2508-5859
Titre abrégé: Ann Hepatobiliary Pancreat Surg
Pays: Korea (South)
ID NLM: 101698342
Informations de publication
Date de publication:
31 May 2022
31 May 2022
Historique:
received:
19
10
2021
revised:
29
12
2021
accepted:
29
12
2021
pubmed:
9
4
2022
medline:
9
4
2022
entrez:
8
4
2022
Statut:
ppublish
Résumé
Traumatic pancreatic injury (TPI) is rare as an isolated injury. There is a trend to perform conservative treatment even in patients with complete duct dissection and successful treatment. This study reviewed our 20 years of experience in the management of TPI and assessed patient outcomes according to age group and treatment strategy. A retrospective analysis of patients diagnosed and treated with TPI at a level-I trauma center from 2000-2019. Patients were divided into two groups: adults and pediatrics. Conservative treatment cases were subjected to subgroup analysis. Level of evidence: IV. Of a total of 77 patients, the mean age was 24.89 ± 15.88 years. Fifty-six (72.7%) patients had blunt trauma with motor vehicle accident. Blunt trauma was the predominant mechanism in 42 (54.5%) patients. Overall, 38 (49.4%) cases had grade I or II injury, 24 (31.2%) had grade III injury, and 15 (19.5%) had grade IV injury. A total of 30 cases had non-operative management (NOM). Successful NOM was observed in 16 (20.8%) cases, including eight (32.0%) pediatric cases and eight (15.4%) adult cases. Higher American association for the surgery of trauma (AAST) grade of injury was associated with NOM failure (16.7% for grade I/II, 100% for grade III, and 66.7% for grade IV injury; High AAST grade TPI is associated with a high rate of NOM failure in both pediatric and adults.
Sections du résumé
Backgrounds/Aims
UNASSIGNED
Traumatic pancreatic injury (TPI) is rare as an isolated injury. There is a trend to perform conservative treatment even in patients with complete duct dissection and successful treatment. This study reviewed our 20 years of experience in the management of TPI and assessed patient outcomes according to age group and treatment strategy.
Methods
UNASSIGNED
A retrospective analysis of patients diagnosed and treated with TPI at a level-I trauma center from 2000-2019. Patients were divided into two groups: adults and pediatrics. Conservative treatment cases were subjected to subgroup analysis. Level of evidence: IV.
Results
UNASSIGNED
Of a total of 77 patients, the mean age was 24.89 ± 15.88 years. Fifty-six (72.7%) patients had blunt trauma with motor vehicle accident. Blunt trauma was the predominant mechanism in 42 (54.5%) patients. Overall, 38 (49.4%) cases had grade I or II injury, 24 (31.2%) had grade III injury, and 15 (19.5%) had grade IV injury. A total of 30 cases had non-operative management (NOM). Successful NOM was observed in 16 (20.8%) cases, including eight (32.0%) pediatric cases and eight (15.4%) adult cases. Higher American association for the surgery of trauma (AAST) grade of injury was associated with NOM failure (16.7% for grade I/II, 100% for grade III, and 66.7% for grade IV injury;
Conclusions
UNASSIGNED
High AAST grade TPI is associated with a high rate of NOM failure in both pediatric and adults.
Identifiants
pubmed: 35393375
pii: ahbps.21-144
doi: 10.14701/ahbps.21-144
pmc: PMC9136422
doi:
Types de publication
Journal Article
Langues
eng
Pagination
190-198Références
J Gastrointest Surg. 2002 Jul-Aug;6(4):587-98
pubmed: 12127126
J Visc Surg. 2015 Dec;152(6):349-55
pubmed: 26476678
J Trauma Acute Care Surg. 2016 Nov;81(5):855-859
pubmed: 27537506
J Trauma Acute Care Surg. 2017 Jan;82(1):185-199
pubmed: 27787438
Injury. 2020 Jan;51(1):59-65
pubmed: 31431334
World J Gastroenterol. 2013 Dec 21;19(47):9003-11
pubmed: 24379625
Injury. 2019 Nov;50(11):1787-1789
pubmed: 31421815
Emerg Radiol. 2013 Aug;20(4):259-66
pubmed: 23604978
Surg Endosc. 2017 Oct;31(10):4201-4210
pubmed: 28281124
Langenbecks Arch Surg. 2011 Oct;396(7):1067-76
pubmed: 21847623
Eur J Trauma Emerg Surg. 2015 Jun;41(3):239-50
pubmed: 26038029
J Am Coll Surg. 2016 Jun;222(6):977-82
pubmed: 26776354
Ann R Coll Surg Engl. 2013 May;95(4):241-5
pubmed: 23676806
Injury. 2014 Sep;45(9):1384-93
pubmed: 24702828
Injury. 2014 Jan;45(1):134-40
pubmed: 23948236
J Pediatr Surg. 2016 Sep;51(9):1526-31
pubmed: 27577183
Injury. 2018 Jan;49(1):27-32
pubmed: 29173964
J Trauma. 1990 Nov;30(11):1427-9
pubmed: 2231822
Int J Surg Case Rep. 2020;71:222-224
pubmed: 32480329
Injury. 2019 Sep;50(9):1522-1528
pubmed: 31164222
J Trauma Acute Care Surg. 2020 Jan;88(1):19-24
pubmed: 31804416