ArticleAnnals of medicine and surgery (2012)2016
Predictors of successful non-operative management of grade III & IV blunt pancreatic trauma.
Article in Annals of medicine and surgery (2012), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 32 citations in OpenAlex.
- Article
- Delayed distal pancreatectomy for isolated complete pancreatic disruption secondary to "trivial" blunt abdominal injury: A case report and literature review.Clinical case reports · 2022Article
- Missed pancreatic injury in patients undergoing conservative management of blunt abdominal trauma: Causes, sequelae and management.Turkish journal of surgery · 2021Article
- Successful nonoperative management by endoscopic and percutaneous drainage for penetrating pancreatic duct injury: a case report.Journal of medical case reports · 2021Article
- Traumatic Pancreatic Injury Presentation, Management, and Outcome: An Observational Retrospective Study From a Level 1 Trauma Center.Frontiers in surgery · 2021Article
- Blame it on the injury: Trauma is a risk factor for pancreatic fistula following distal pancreatectomy compared with elective resection.The journal of trauma and acute care surgery · 2019Article
- Duodeno-pancreatic and extrahepatic biliary tree trauma: WSES-AAST guidelines.World journal of emergency surgery : WJES · 2019Review
- Pancreatic fracture: a rare complication following scoliosis surgery.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2018Article
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionAlthough surgery is the preferred treatment for grade III&IV pancreatic trauma, there is a growing movement for non-operative management. in blunt pancreatic trauma. Very few studies compare operative versus non-operative management in adult patients.
methodsRetrospective analysis of a prospectively maintained database was performed from 2004 to 2013 in the department of gastrointestinal surgery, NIMS, Hyderabad. Comparative analysis was performed between patients who failed versus those who were successfully managed with non-operative management.
results34 patients had grade III/IV trauma out of which 8 were operated early with the remaining 26 initially under a NOM strategy, 10 of them could be successfully managed without any operation. Post-traumatic pancreatitis, Necrotizing pancreatitis, Ileus, contusion on CT, surrounding organ injuries are independently associated with failure of NOM on a univariate analysis. On multivariate logistic regression presence of necrosis& associated organ injury are factors that predict failure of NOM independently. Development of a pseudocyst is the only significant factor that is associated with a success of NOM.
conclusionsNon-operative measures should be attempted in a select group of grade III&IV blunt pancreatic trauma. In hemodynamically stable patients with a controlled leak walled off as a pseudocyst without associated organ injuries and pancreatic necrosis, NOM has a higher success rate.
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