INTRODUCTION: Recent literature supports a conservative trend in the management of pancreatic injuries. Contrary to this trend, some recommend defining ductal integrity by pancreatography, implying that the results alter management. This study examines our recent 5-year experience with a simplified approach to all pancreatic injuries. METHODS: Retrospective analysis of patients sustaining pancreatic injuries was performed. RESULTS: One hundred thirty-four patients were identified. Overall mortality was 13%, and pancreatic-related mortality was 2%. Analyses were based on 124 pancreatic injuries among patients who survived >12 hours. Thirty-seven proximal injuries were treated with drainage alone, with a pancreatic morbidity of 11%. Eighty-seven distal pancreatic injuries occurred, 54 with indeterminate ductal status. Twenty-four had high probability for duct injury and were treated by distal resection; 30 with a low probability of ductal injury were drained. Pancreatic morbidity was not different between these groups. CONCLUSIONS: Pancreatic injuries including those with indeterminate ductal status can be successfully managed with low morbidity and mortality using this simplified management protocol.
INTRODUCTION: Recent literature supports a conservative trend in the management of pancreatic injuries. Contrary to this trend, some recommend defining ductal integrity by pancreatography, implying that the results alter management. This study examines our recent 5-year experience with a simplified approach to all pancreatic injuries. METHODS: Retrospective analysis of patients sustaining pancreatic injuries was performed. RESULTS: One hundred thirty-four patients were identified. Overall mortality was 13%, and pancreatic-related mortality was 2%. Analyses were based on 124 pancreatic injuries among patients who survived >12 hours. Thirty-seven proximal injuries were treated with drainage alone, with a pancreatic morbidity of 11%. Eighty-seven distal pancreatic injuries occurred, 54 with indeterminate ductal status. Twenty-four had high probability for duct injury and were treated by distal resection; 30 with a low probability of ductal injury were drained. Pancreatic morbidity was not different between these groups. CONCLUSIONS:Pancreatic injuries including those with indeterminate ductal status can be successfully managed with low morbidity and mortality using this simplified management protocol.
Authors: Z Bozdag; M Kapan; B V Ulger; A Turkoglu; O Uslukaya; A Oğuz; M Aldemir Journal: Eur J Trauma Emerg Surg Date: 2015-04-08 Impact factor: 3.693
Authors: Elizaveta Ragulin-Coyne; Elan R Witkowski; Zeling Chau; Daniel Wemple; Sing Chau Ng; Heena P Santry; Shimul A Shah; Jennifer F Tseng Journal: HPB (Oxford) Date: 2013-07-22 Impact factor: 3.647