| Title: |
Pancreaticoduodenectomy in Trauma Patients with Grade IV-V Duodenal or Pancreatic Injuries: A Post Hoc Analysis of an EAST Multicenter Trial |
| Authors: |
Choron, Rachel Leah; Piplani, Charoo; Kuzinar, Julia; Teichman, Amanda L.; Bargoud, Christopher; Sciarretta, Jason D.; Smith, Randi N.; Hanos, Dustin; Afif, Iman N.; Beard, Jessica H.; Dhillon, Navpreet Kaur; Zhang, Ashling; Ghneim, Mira; Devasahayam, Rebekah; Gunter, Oliver; Smith, Alison A.; Sun, Brandi; Cao, Chloe S.; Reynolds, Jessica K.; Hilt, Lauren A.; Holena, Daniel N.; Chang, Grace; Jonikas, Meghan; Echeverria-Rosario, Karla; Fung, Nathaniel S.; Anderson, Aaron; Fitzgerald, Caitlin A.; Dumas, Ryan Peter; Levin, Jeremy H.; Trankiem, Christine T.; Yoon, JaeHee; Blank, Jacqueline; Hazelton, Joshua P.; McLaughlin, Christopher J.; Al-Aref, Rami; Kirsch, Jordan Michael; Howard, Daniel S.; Scantling, Dane R.; Dellonte, Kate; Vella, Michael A.; Hopkins, Brent; Shell, Chloe; Udekwu, Pascal; Wong, Evan G.; Joseph, Bellal; Lieberman, Howard; Ramsey, Walter A.; Stewart, Collin H.; Alvarez, Claudia; Berne, John D.; Nahmias, Jeffry; Puente, Ivan; Patton, Joe; Rakitin, Ilya; Perea, Lindsey; Pulido, Odessa; Ahmed, Hashim; Keating, Jane; Kodadek, Lisa M; Wade, Jason; Reynold, Henry; Schreiber, Martin; Benjamin, Andrew; Khan, Abid; Mann, Laura K.; Mentzer, Caleb; Mousafeiris, Vasileios; Mulita, Francesk; Reid-Gruner, Shari; Sais, Erica; Foote, Christopher W.; Palacio, Carlos H.; Argandykov, Dias; Kaafarani, Haytham; Bover Manderski, Michelle T.; Moko, Lilamarie; Narayan, Mayur; Seamon, Mark |
| Source: |
SKMC Student Presentations and Publications |
| Publisher Information: |
Jefferson Digital Commons |
| Publication Year: |
2024 |
| Collection: |
Jefferson Digital Commons (Thomas Jefferson University, Philadelphia) |
| Subject Terms: |
abdominal injuries; duodenum; multiple trauma; pancreas; Medical Specialties; Medicine and Health Sciences; Surgery |
| Description: |
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 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. |
| Document Type: |
text |
| File Description: |
application/pdf |
| Language: |
English |
| Relation: |
https://jdc.jefferson.edu/skmcstudentworks/35; https://jdc.jefferson.edu/context/skmcstudentworks/article/1034/viewcontent/e001438.full.pdf |
| Availability: |
https://jdc.jefferson.edu/skmcstudentworks/35; https://jdc.jefferson.edu/context/skmcstudentworks/article/1034/viewcontent/e001438.full.pdf |
| Rights: |
http://creativecommons.org/licenses/by-nc/4.0/ |
| Accession Number: |
edsbas.95FB3355 |
| Database: |
BASE |