Benjamin Menahem1, Chetana Lim2, Eylon Lahat1, Chady Salloum1, Michael Osseis1, Laurence Lacaze1, Philippe Compagnon3, Gerard Pascal1, Daniel Azoulay3. 1. Department of Hepatobiliary, Pancreatic Surgery and Liver transplantation, Henri Mondor Hospital, Créteil, France. 2. Department of Hepatobiliary, Pancreatic Surgery and Liver transplantation, Henri Mondor Hospital, Créteil, France;; INSERM, U965, Paris, France. 3. Department of Hepatobiliary, Pancreatic Surgery and Liver transplantation, Henri Mondor Hospital, Créteil, France;; INSERM, U955, Créteil, France.
Abstract
BACKGROUND: The management of pancreatic trauma is complex. The aim of this study was to report our experience in the management of pancreatic trauma. METHODS: All patients hospitalized between 2005 and 2013 for pancreatic trauma were included. Traumatic injuries of the pancreas were classified according to the American Association for Surgery of Trauma (AAST) in five grades. Mortality and morbidity were analyzed. RESULTS: A total of 30 patients were analyzed (mean age: 38±17 years). Nineteen (63%) patients had a blunt trauma and 12 (40%) had pancreatic injury ≥ grade 3. Fifteen patients underwent exploratory laparotomy and the other 15 patients had nonoperative management (NOM). Four (13%) patients had a partial pancreatectomy [distal pancreatectomy (n=3) and pancreaticoduodenectomy (n=1)]. Overall, in hospital mortality was 20% (n=6). Postoperative mortality was 27% (n=4/15). Mortality of NOM group was 13% (n=2/15) in both cases death was due to severe head injury. Among the patients who underwent NOM, three patients had injury ≥ grade 3, one patient had a stent placement in the pancreatic duct and two patients underwent endoscopic drainage of a pancreatic pseudocyst. CONCLUSIONS: Operative management of pancreatic trauma leads to a higher mortality. This must not be necessarily related to the pancreas injury alone but also to the associated injuries including liver, spleen and vascular trauma which may cause impaired outcome more than pancreas injury.
BACKGROUND: The management of pancreatic trauma is complex. The aim of this study was to report our experience in the management of pancreatic trauma. METHODS: All patients hospitalized between 2005 and 2013 for pancreatic trauma were included. Traumatic injuries of the pancreas were classified according to the American Association for Surgery of Trauma (AAST) in five grades. Mortality and morbidity were analyzed. RESULTS: A total of 30 patients were analyzed (mean age: 38±17 years). Nineteen (63%) patients had a blunt trauma and 12 (40%) had pancreatic injury ≥ grade 3. Fifteen patients underwent exploratory laparotomy and the other 15 patients had nonoperative management (NOM). Four (13%) patients had a partial pancreatectomy [distal pancreatectomy (n=3) and pancreaticoduodenectomy (n=1)]. Overall, in hospital mortality was 20% (n=6). Postoperative mortality was 27% (n=4/15). Mortality of NOM group was 13% (n=2/15) in both cases death was due to severe head injury. Among the patients who underwent NOM, three patients had injury ≥ grade 3, one patient had a stent placement in the pancreatic duct and two patients underwent endoscopic drainage of a pancreatic pseudocyst. CONCLUSIONS: Operative management of pancreatic trauma leads to a higher mortality. This must not be necessarily related to the pancreas injury alone but also to the associated injuries including liver, spleen and vascular trauma which may cause impaired outcome more than pancreas injury.
Authors: E E Moore; T H Cogbill; M A Malangoni; G J Jurkovich; H R Champion; T A Gennarelli; J W McAninch; H L Pachter; S R Shackford; P G Trafton Journal: J Trauma Date: 1990-11
Authors: Herb A Phelan; George C Velmahos; Gregory J Jurkovich; Randall S Friese; Joseph P Minei; Jay A Menaker; Allan Philp; Heather L Evans; Martin L Gunn; Alexander L Eastman; Susan E Rowell; Carrie E Allison; Ronald L Barbosa; Scott H Norwood; Malek Tabbara; Christopher J Dente; Matthew M Carrick; Matthew J Wall; Jim Feeney; Patrick J O'Neill; Gujjarappa Srinivas; Carlos V R Brown; Andrew C Reifsnyder; Moustafa O Hassan; Scott Albert; Jose L Pascual; Michelle Strong; Forrest O Moore; David A Spain; Mary-Anne Purtill; Byard Edwards; Jason Strauss; Rodney M Durham; Juan C Duchesne; Patrick Greiffenstein; C Clay Cothren Journal: J Trauma Date: 2009-03
Authors: Federico Coccolini; Leslie Kobayashi; Yoram Kluger; Ernest E Moore; Luca Ansaloni; Walt Biffl; Ari Leppaniemi; Goran Augustin; Viktor Reva; Imitiaz Wani; Andrew Kirkpatrick; Fikri Abu-Zidan; Enrico Cicuttin; Gustavo Pereira Fraga; Carlos Ordonez; Emmanuil Pikoulis; Maria Grazia Sibilla; Ron Maier; Yosuke Matsumura; Peter T Masiakos; Vladimir Khokha; Alain Chichom Mefire; Rao Ivatury; Francesco Favi; Vassil Manchev; Massimo Sartelli; Fernando Machado; Junichi Matsumoto; Massimo Chiarugi; Catherine Arvieux; Fausto Catena; Raul Coimbra Journal: World J Emerg Surg Date: 2019-12-11 Impact factor: 5.469