Management of pancreatic injuries during damage control surgery: an observational outcomes analysis of 79 patients treated at an academic Level 1 trauma centre

Background This study evaluated factors influencing mortality in a large cohort of patients who sustained pancreatic injuries and underwent DCS. Methods A prospective database of consecutive patients with pancreatic injuries treated at a Level 1 academic trauma centre was reviewed to identify those...

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Bibliographic Details
Published in:European journal of trauma and emergency surgery (Munich : 2007) 2017-06, Vol.43 (3), p.411-420
Main Authors: Krige, J. E. J., Kotze, U. K., Setshedi, M., Nicol, A. J., Navsaria, P. H.
Format: Article
Language:English
Subjects:
Abdominal Injuries - surgery
Adolescent
Adult
Aged
Critical Care Medicine
Databases, Factual
Emergency Medicine
Female
Hospitals, University
Humans
Intensive
Male
Medicine
Medicine & Public Health
Middle Aged
Mortality
Original Article
Outcome Assessment (Health Care)
Pancreas - injuries
Pancreas - surgery
Pancreatectomy - methods
Prospective Studies
South Africa
Sports Medicine
Surgery
Surgical Orthopedics
Trauma
Trauma Centers
Traumatic Surgery
Young Adult
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Summary:Background This study evaluated factors influencing mortality in a large cohort of patients who sustained pancreatic injuries and underwent DCS. Methods A prospective database of consecutive patients with pancreatic injuries treated at a Level 1 academic trauma centre was reviewed to identify those who underwent DCS between 1995 and 2014. Results Seventy-nine (71 men, median age: 26 years, range 16–73 years, gunshot wounds = 62, blunt = 14, stab = 3) patients with pancreatic injuries (35 proximal, 44 distal) had DCS. Fifty-nine (74.7 %) patients had AAST grade 3, 4 or 5 pancreatic injuries. The 79 patients had a total of 327 associated injuries (mean: 3 per patient, range 0–6) and underwent a total of 187 (range 1–7) operations. Vascular injuries (60/327, 18.3 %) occurred in 41 patients. Twenty-seven (34.2 %) patients died without having a second operation. The remaining 52 patients had two or more laparotomies (range 2–7). Overall 28 (35 %) patients underwent a pancreatic resection either during DCS ( n  = 18) or subsequently as a secondary procedure ( n  = 10) including a Whipple ( n  = 6) when stable. Overall 43 (54.4 %) patients died. Mortality was related to associated vascular injuries overall ( p  
ISSN:1863-9933
1863-9941
DOI:10.1007/s00068-016-0657-6