Evidence map›Paper›PMID 39717488›Full record

ArticleTrauma surgery & acute care open2024

Pancreaticoduodenectomy in trauma patients with grade IV-V duodenal or pancreatic injuries: a post hoc analysis of an EAST multicenter trial.

Rachel Leah Choron, Charoo Piplani, Julia Kuzinar, Amanda L Teichman, Christopher Bargoud, Jason D Sciarretta, Randi N Smith, Dustin Hanos, Iman N Afif, Jessica H Beard and 68 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Trauma surgery & acute care open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Pancreaticoduodenectomy in trauma patients.Trauma surgery & acute care open · 2025
    Article
  3. Pancreaticoduodenectomy in grade V injuries.Trauma surgery & acute care open · 2025
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

78 authors.

Rachel Leah ChoronSurgery, Division of Acute Care Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.ORCID 0000-0002-2297-9956
Charoo PiplaniRutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
Julia KuzinarSurgery, Division of Acute Care Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
Amanda L TeichmanSurgery, Division of Acute Care Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.ORCID 0000-0003-4120-8345
Christopher BargoudRutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
Jason D SciarrettaSurgery, Emory University School of Medicine, Atlanta, Georgia, USA.
Randi N SmithTrauma/Surgical Critical Care, Emory University School of Medicine, Atlanta, Georgia, USA.ORCID 0000-0002-2720-5917
Dustin HanosGrady Memorial Hospital Corp, Atlanta, Georgia, USA.
Iman N AfifTemple University Hospital, Philadelphia, Pennsylvania, USA.
Jessica H BeardSurgery, Temple University, Philadelphia, Pennsylvania, USA.
Navpreet Kaur DhillonR Adams Cowley Shock Trauma Center, Baltimore, Maryland, USA.ORCID 0000-0003-1361-8582
Ashling ZhangUniversity of Maryland School of Medicine, Baltimore, Maryland, USA.
Mira GhneimR Adams Cowley Shock Trauma Center, Baltimore, Maryland, USA.
Rebekah DevasahayamVanderbilt University Medical Center, Nashville, Tennessee, USA.
Oliver GunterTrauma/Surgical Critical Care, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
Alison A SmithLouisiana State University Health Sciences Center, New Orleans, Louisiana, USA.ORCID 0000-0002-1742-3160
Brandi SunLouisiana State University Health Sciences Center, New Orleans, Louisiana, USA.
Chloe S CaoUniversity of Kentucky, Lexington, Kentucky, USA.
Jessica K ReynoldsUniversity of Kentucky, Lexington, Kentucky, USA.
Lauren A HiltMedical College of Wisconsin, Milwaukee, Wisconsin, USA.
Daniel N HolenaMedical College of Wisconsin, Milwaukee, Wisconsin, USA.
Grace ChangSurgery, Mount Sinai Hospital, Chicago, Illinois, USA.ORCID 0000-0002-1987-0888
Meghan JonikasDepartment of Surgery, Mount Sinai Hospital, Chicago, Illinois, USA.
Karla Echeverria-RosarioCooper University Hospital Regional Trauma Center, Camden, New Jersey, USA.
Nathaniel S FungRiverside University Health System Medical Center, Moreno Valley, California, USA.
Aaron AndersonIndiana University Health Methodist Hospital, Indianapolis, Indiana, USA.
Caitlin A FitzgeraldThe University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Ryan Peter DumasUT Southwestern Medical, Dallas, Texas, USA.ORCID 0000-0002-6566-1833
Jeremy H LevinIndiana University Health Methodist Hospital, Indianapolis, Indiana, USA.
Christine T TrankiemMedStar Washington Hospital Center, Washington, District of Columbia, USA.
JaeHee YoonMedStar Washington Hospital Center, Washington, District of Columbia, USA.
Jacqueline BlankUniversity of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Joshua P HazeltonWellSpan Health, York, Pennsylvania, USA.
Christopher J McLaughlinPenn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, USA.
Rami Al-ArefWashington University School of Medicine in Saint Louis, St Louis, Missouri, USA.
Jordan Michael KirschWashington University School of Medicine in Saint Louis, St Louis, Missouri, USA.ORCID 0000-0001-8314-1180
Daniel S HowardBoston Medical Center, Boston, Massachusetts, USA.
Dane R ScantlingBoston Medical Center, Boston, Massachusetts, USA.
Kate DellonteUniversity of Rochester, Rochester, New York, USA.
Michael A VellaSurgery, University of Rochester Medical Center, Rochester, New York, USA.ORCID 0000-0002-8690-4443
Brent HopkinsMcGill University, Montreal, Quebec, Canada.
Chloe ShellWakeMed Health and Hospitals, Raleigh, North Carolina, USA.
Pascal UdekwuSurgery, WakeMed Health and Hospitals, Raleigh, North Carolina, USA.ORCID 0000-0002-7724-8034
Evan G WongMcGill University, Montreal, Quebec, Canada.
Bellal JosephUniversity of Arizona Medical Center - University Campus, Tucson, Arizona, USA.
Howard LiebermanJackson Memorial Hospital, Miami, Florida, USA.
Walter A RamseyJackson Memorial Hospital, Miami, Florida, USA.
Collin H StewartUniversity of Arizona Medical Center - University Campus, Tucson, Arizona, USA.
Claudia AlvarezUniversity of California Irvine School of Medicine, Irvine, California, USA.
John D BerneBroward Health Medical Center, Fort Lauderdale, Florida, USA.
Jeffry NahmiasUniversity of California Irvine School of Medicine, Irvine, California, USA.
Ivan PuenteBroward Health Medical Center, Fort Lauderdale, Florida, USA.
Joe PattonSurgery, Henry Ford Hospital, Detroit, Michigan, USA.ORCID 0000-0002-8779-6632
Ilya RakitinHenry Ford Hospital, Detroit, Michigan, USA.
Lindsey PereaLancaster General Health, Lancaster, Pennsylvania, USA.
Odessa PulidoLancaster General Health, Lancaster, Pennsylvania, USA.
Hashim AhmedSurgery, Texas Health Harris Methodist Hospital Fort Worth, Fort Worth, Texas, USA.
Jane KeatingHartford Hospital, Hartford, Connecticut, USA.
Lisa M KodadekSurgery, Yale University School of Medicine, New Haven, Connecticut, USA.ORCID 0000-0001-6433-9159
Jason WadeHartford Hospital, Hartford, Connecticut, USA.
Henry ReynoldOregon Health & Science University, Portland, Oregon, USA.
Martin SchreiberSurgery, Oregon Health and Science University, Portland, Oregon, USA.ORCID 0000-0002-4430-6779
Andrew BenjaminThe University of Chicago Medicine, Chicago, Illinois, USA.
Abid KhanThe University of Chicago Medicine, Chicago, Illinois, USA.
Laura K MannSpartanburg Regional Medical Center, Spartanburg, South Carolina, USA.
Caleb MentzerDepartment of Surgery, University of Texas McGovern Medical School, Houston, Texas, USA.
Vasileios MousafeirisUniversity General Hospital of Patras, Patra, Greece.
Francesk MulitaUniversity General Hospital of Patras, Patra, Greece.
Shari Reid-GrunerThomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
Erica SaisThomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
Christopher W FooteTrauma Services Department, South Texas Health System, McAllen, Texas, USA.ORCID 0000-0001-5299-0139
Carlos H PalacioSouth Texas Health System, Edinburg, Texas, USA.
Dias ArgandykovMassachusetts General Hospital, Boston, Massachusetts, USA.
Haytham KaafaraniMassachusetts General Hospital, Boston, Massachusetts, USA.
Michelle T Bover ManderskiRutgers School of Public Health, Piscataway, New Jersey, USA.
Lilamarie MokoSurgery, Division of Acute Care Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
Mayur NarayanSurgery, Division of Acute Care Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
Mark SeamonUniversity of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: The utility of pancreaticoduodenectomy (PD) for high-grade traumatic injuries remains unclear and data surrounding its use are limited. We hypothesized that PD does not result in improved outcomes when compared with non-PD surgical management of grade IV-V pancreaticoduodenal injuries. Methods: This is a retrospective, multicenter analysis from 35 level 1 trauma centers from January 2010 to December 2020. Included patients were ≥15 years of age with the American Association for the Surgery of Trauma grade IV-V duodenal and/or pancreatic injuries. The study compared operative repair strategy: PD versus non-PD. Results: The sample (n=95) was young (26 years), male (82%), with predominantly penetrating injuries (76%). There was no difference in demographics, hemodynamics, or blood product requirement on presentation between PD (n=32) vs non-PD (n=63). Anatomically, PD patients had more grade V duodenal, grade V pancreatic, ampullary, and pancreatic ductal injuries compared with non-PD patients (all p<0.05). 43% of all grade V duodenal injuries and 40% of all grade V pancreatic injuries were still managed with non-PD. One-third of non-PD duodenal injuries were managed with primary repair alone. PD patients had more gastrointestinal (GI)-related complications, longer intensive care unit length of stay (LOS), and longer hospital LOS compared with non-PD (all p<0.05). There was no difference in mortality or readmission. Multivariable logistic regression analysis determined PD to be associated with a 3.8-fold greater odds of GI complication (p=0.010) compared with non-PD. In a subanalysis of patients without ampullary injuries (n=60), PD patients had more anastomotic leaks compared with the non-PD group (3 (30%) vs 2 (4%), p Conclusion: While PD patients did not have worse hemodynamics or blood product requirements on admission, they sustained more complex anatomic injuries and had more GI complications and longer LOS than non-PD patients. We suggest that the role of PD should be limited to cases of massive destruction of the pancreatic head and ampullary complex, given the likely procedure-related morbidity and adverse outcomes when compared with non-PD management. Level of evidence: IV, Multicenter retrospective comparative study.

Indexed as

abdominal injuriesduodenummultiple traumapancreas

Identifiers

PMID39717488
PMCPMC11664373

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