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Outcomes following operative vs. non-operative management of blunt traumatic pancreatic injuries: a retrospective multi-institutional study

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Burns & Trauma 2016年第4期4卷 316-322页

作者： Poppy Addison Toni Iurcotta Leo I.Amodu Geoffrey Crandall Meredith Akerman Daniel Galvin Annemarie Glazer Nathan christopherson Jose Prince Matthew Bank christopher sorrentino Joaquin Cagliani Jeffrey Nicastro Gene Coppa Ernesto P.Molmenti Horacio L.Rodriguez Rilo Department of Surgery Hofstra-Northwell School of MedicineHempsteadNYUSA Pancreas Disease Center Northwell HealthManhassetNYUSA Department of Surgery Hofstra-Northwell School of MedicineHempsteadNYUSA Department of Biostatistics Feinstein Institute for Medical ResearchManhassetNYUSA Pancreas Disease Center Northwell HealthManhassetNYUSA Department of Surgery Hofstra-Northwell School of MedicineHempsteadNYUSA Pancreas Disease Center Northwell HealthManhassetNYUSA Northwell Health 900 Northern BoulevardSuite 150Great NeckNY 11020USA

Background:Traumatic pancreatic injuries are rare,and guidelines specifying management are controversial and difficult to apply in the acute clinical *** to sparse data on these injuries,we carried out a retrospective review to determine outcomes following surgical or non-surgical management of traumatic pancreatic *** hypothesize a higher morbidity and mortality rate in patients treated surgically when compared to patients treated ***:We performed a retrospective review of data from four trauma centers in New York from 1990–2014,comparing patients who had blunt traumatic pancreatic injuries who were managed operatively to those managed *** compared continuous variables using the Mann-Whitney U test and categorical variables using the chi-square and Fisher’s exact *** analysis was performed to determine the possible confounding factors associated with mortality in both treatment ***:Twenty nine patients were managed operatively and 32 *** was a significant difference between the operative and non-operative groups in median age(37.0 vs.16.2 years,P=0.016),grade of pancreatic injury(grade I;30.8 vs.85.2%,P value for all comparisons<0.0001),median injury severity score(ISS)(16.0 vs.4.0,P=0.002),blood transfusion(55.2 vs.15.6%,P=0.0012),other abdominal injuries(79.3 vs.38.7%,P=0.0014),pelvic fractures(17.2 vs.0.00%,P=0.020),intensive care unit(ICU)admission(86.2 vs.50.0%,P=0.003),median length of stay(LOS)(16.0 vs.4.0 days,P<0.0001),and mortality(27.6 vs.3.1%,P=0.010).Conclusions:Patients with traumatic pancreatic injuries treated operatively were more severely injured and suffered greater complications than those treated *** greater morbidity and mortality associated with these patients warrants further study to determine optimal triage strategies and which subset of patients is likely to benefit from surgery.

关键词： Injury Management Non-operative Operative Pancreas Trauma

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