Management of Traumatic Pancreatic Injuries: Evaluation of 7 Years of Experience at a Single Regional Trauma Center
Purpose Traumatic pancreatic injuries are rare, but their diagnosis and management are challenging. The aim of this study was to evaluate and report our experiences with the management of pancreatic injuries. Methods We identified all adult patients (age >15) with pancreatic injuries from our tra...
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| Format: | Article |
| Language: | English |
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Korean Society of Traumatology
2021-09-01
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| Series: | Journal of Trauma and Injury |
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| Online Access: | http://jtraumainj.org/upload/pdf/jti-2021-0070.pdf |
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| author | Min A Lee Seung Hwan Lee Kang Kook Choi Youngeun Park Gil Jae Lee Byungchul Yu |
| author_facet | Min A Lee Seung Hwan Lee Kang Kook Choi Youngeun Park Gil Jae Lee Byungchul Yu |
| author_sort | Min A Lee |
| collection | DOAJ |
| description | Purpose Traumatic pancreatic injuries are rare, but their diagnosis and management are challenging. The aim of this study was to evaluate and report our experiences with the management of pancreatic injuries. Methods We identified all adult patients (age >15) with pancreatic injuries from our trauma registry over a 7-year period. Data related to patients’ demographics, diagnoses, operative information, complications, and hospital course were abstracted from the registry and medical records. Results A total of 45 patients were evaluated. Most patients had blunt trauma (89%) and 21 patients (47%) had pancreatic injuries of grade 3 or higher. Twenty-eight patients (62%) underwent laparotomy and 17 (38%) received nonoperative management (NOM). The overall in-hospital mortality rate was 24% (n=11), and only one patient died after NOM (due to a severe traumatic brain injury). Twenty-two patients (79%) underwent emergency laparotomy and six (21%) underwent delayed laparotomy. A drainage procedure was performed in 12 patients (43%), and pancreatectomy was performed in 16 patients (57%) (distal pancreatectomy [DP], n=8; DP with spleen preservation, n=5; pancreaticoduodenectomy, n=2; total pancreatectomy, n=1). Fourteen (31%) pancreas-specific complications occurred, and all complications were successfully managed without surgery. Solid organ injuries (n=14) were the most common type of associated abdominal injury (Abbreviated Injury Scale ≥3). Conclusions For traumatic pancreatic injuries, an appropriate treatment method should be considered after evaluation of the accompanying injury and the patient’s hemodynamic status. NOM can be performed without mortality in appropriately selected cases. |
| format | Article |
| id | doaj-art-92f763bccf424276aba9eb5bb404b184 |
| institution | Kabale University |
| issn | 2799-4317 2287-1683 |
| language | English |
| publishDate | 2021-09-01 |
| publisher | Korean Society of Traumatology |
| record_format | Article |
| series | Journal of Trauma and Injury |
| spelling | doaj-art-92f763bccf424276aba9eb5bb404b1842025-01-16T02:21:32ZengKorean Society of TraumatologyJournal of Trauma and Injury2799-43172287-16832021-09-0134317718210.20408/jti.2021.00701088Management of Traumatic Pancreatic Injuries: Evaluation of 7 Years of Experience at a Single Regional Trauma CenterMin A Lee0Seung Hwan Lee1Kang Kook Choi2Youngeun Park3Gil Jae Lee4Byungchul Yu5 Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, Korea Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, Korea Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, Korea Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, Korea Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, Korea Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, KoreaPurpose Traumatic pancreatic injuries are rare, but their diagnosis and management are challenging. The aim of this study was to evaluate and report our experiences with the management of pancreatic injuries. Methods We identified all adult patients (age >15) with pancreatic injuries from our trauma registry over a 7-year period. Data related to patients’ demographics, diagnoses, operative information, complications, and hospital course were abstracted from the registry and medical records. Results A total of 45 patients were evaluated. Most patients had blunt trauma (89%) and 21 patients (47%) had pancreatic injuries of grade 3 or higher. Twenty-eight patients (62%) underwent laparotomy and 17 (38%) received nonoperative management (NOM). The overall in-hospital mortality rate was 24% (n=11), and only one patient died after NOM (due to a severe traumatic brain injury). Twenty-two patients (79%) underwent emergency laparotomy and six (21%) underwent delayed laparotomy. A drainage procedure was performed in 12 patients (43%), and pancreatectomy was performed in 16 patients (57%) (distal pancreatectomy [DP], n=8; DP with spleen preservation, n=5; pancreaticoduodenectomy, n=2; total pancreatectomy, n=1). Fourteen (31%) pancreas-specific complications occurred, and all complications were successfully managed without surgery. Solid organ injuries (n=14) were the most common type of associated abdominal injury (Abbreviated Injury Scale ≥3). Conclusions For traumatic pancreatic injuries, an appropriate treatment method should be considered after evaluation of the accompanying injury and the patient’s hemodynamic status. NOM can be performed without mortality in appropriately selected cases.http://jtraumainj.org/upload/pdf/jti-2021-0070.pdfwounds and injuriespancreas |
| spellingShingle | Min A Lee Seung Hwan Lee Kang Kook Choi Youngeun Park Gil Jae Lee Byungchul Yu Management of Traumatic Pancreatic Injuries: Evaluation of 7 Years of Experience at a Single Regional Trauma Center Journal of Trauma and Injury wounds and injuries pancreas |
| title | Management of Traumatic Pancreatic Injuries: Evaluation of 7 Years of Experience at a Single Regional Trauma Center |
| title_full | Management of Traumatic Pancreatic Injuries: Evaluation of 7 Years of Experience at a Single Regional Trauma Center |
| title_fullStr | Management of Traumatic Pancreatic Injuries: Evaluation of 7 Years of Experience at a Single Regional Trauma Center |
| title_full_unstemmed | Management of Traumatic Pancreatic Injuries: Evaluation of 7 Years of Experience at a Single Regional Trauma Center |
| title_short | Management of Traumatic Pancreatic Injuries: Evaluation of 7 Years of Experience at a Single Regional Trauma Center |
| title_sort | management of traumatic pancreatic injuries evaluation of 7 years of experience at a single regional trauma center |
| topic | wounds and injuries pancreas |
| url | http://jtraumainj.org/upload/pdf/jti-2021-0070.pdf |
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