Journal article
Non-operative management of high-grade pancreatic trauma: Is it worth the wait?
Journal of pediatric surgery, v 48(5), pp 1060-1064
01 May 2013
PMID: 23701783
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Whether children with pancreatic trauma should be managed non-operatively or operatively is controversial. We reviewed outcomes of high-grade pancreatic injuries at two high-volume pediatric surgical centres comparing non-operative and operative management strategies.
All pancreatic traumas presenting from January 1993 to July 2010 were reviewed. Patients with high-grade pancreatic injuries were stratified based on early operative or non-operative therapy. Baseline characteristics and outcomes were compared. Regression analyses were performed to assess complication rates, length of stay, and TPN duration while controlling for injury severity score and associated injuries.
Of 77 patients with pancreatic injuries, 39 were grade 3 or higher. The mean ISS was 19.2±10.8. Nineteen patients (50%) had associated injuries. Fifteen patients (38%) were managed operatively. Baseline characteristics were similar between groups other than ISS (p=0.03). Duration of hospitalization (p=0.01), days of TPN (p=0.003), and overall complications (p=0.007) were higher in non-operative patients. Controlling for both ISS and any associated injury, non-operative management was associated with more complications (OR 8.11; 95% CI 1.60–41.23) and was a significant predictor of prolonged TPN (13days longer; p=0.024).
Primary non-operative management of high-grade pancreatic injuries is associated with a significant increase in complications and TPN dependency. Early operative intervention should be pursued whenever feasible.
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Details
- Title
- Non-operative management of high-grade pancreatic trauma: Is it worth the wait?
- Creators
- Alana L. Beres - University of TorontoPaul W. Wales - University of TorontoEmily R. Christison-Lagay - University of TorontoMary Elizabeth McClure - University of Louisville HospitalMary E. Fallat - University of Louisville HospitalMary E. Brindle - University of Calgary
- Publication Details
- Journal of pediatric surgery, v 48(5), pp 1060-1064
- Publisher
- Elsevier
- Number of pages
- 5
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Surgery
- Web of Science ID
- WOS:000320372100037
- Scopus ID
- 2-s2.0-84877982354
- Other Identifier
- 991021969585904721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Pediatrics
- Surgery