Observational studyWorld journal of emergency surgery : WJES2025
How are duodenal trauma managed? A French nationwide study.
Observational study in World journal of emergency surgery : WJES, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06058975 (National Retrospective Study of Duodenal Trauma), which is not on this map. Not yet cited in PubMed.
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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.
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National Retrospective Study of Duodenal Trauma
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45 authors.
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Abstract
backgroundDuodenal injuries are rare, associated with a significant morbidity. Their management is challanging and remains controversial.
methodsA retrospective study of all consecutive patients with duodenal trauma managed in 21 French trauma centers from 2004 to 2023. Clinical data, trauma mechanisms, injury severity, treatment modalities and outcomes were collected. Specific attention was given to surgical techniques such as damage control laparotomy, primary repair only and duodenal diversion. Statistical analysis was performed to identify factors associated with duodenal leak, severe morbidity and mortality.
resultsOne hundred and thirty-five patients (71.7% male, mean age 35 years) were included, 64% with blunt trauma. Duodenal AAST grades I-II occurred in 68.2% and grades III-V in 31.8%. A discrepancy between radiologic evaluation and intraoperative observations was present in 30.8% of cases, underestimating injury severity in 29.1%. Initial management was nonoperative for 12.7%. Damage control laparotomy was required in 36.6%. Operated patients underwent direct suture (69.2%), duodenal resection (24.4%), duodenal diversion (35.8%). Duodenal leaks occurred in 23.7%, significantly increased by hemodynamic instability (OR = 3.08, p = 0.015) and associated pancreatic trauma (OR = 2.44, p = 0.044). Reoperation rate was 18.5%, for missed duodenal injury (16%) and/or for duodenal leak (32%). Mean length of stay was 27 days. Major morbidity was 27.4% and 30-day mortality 10.4%. The injury severity score was the only predictive factor of major morbidity and mortality.
conclusionsDuodenal trauma remains a severe condition managed mostly with primary repair, where duodenal leak-significantly associated with hemodynamic instability and pancreatic injury, is a major driver of reintervention.
trial registrationThis study was registered on Clinical Trials under the registration numbe NCT06058975.
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