From surveillance to surgery: The delayed implications of non-operative and operative management of pancreatic injuries - 17/10/23
, Tanya Anand , Sai Krishna Bhogadi , Adam Nelson , Hamidreza Hosseinpour , Collin Stewart , Audrey L. Spencer , Christina Colosimo , Michael Ditillo , Bellal Joseph ⁎ Abstract |
Background |
Our study compares the delayed outcomes of operative versus nonoperative management of pancreatic injuries.
Methods |
We analyzed the 2017 Nationwide Readmissions Database on adult (≥18 years) trauma patients with pancreatic injuries. Patients who died on index admission were excluded. Patients were stratified into operative (OP) and non-operative (NOP) groups and compared for outcomes within 90 days of discharge. Multivariable regression analyses were performed.
Results |
We identified 1553 patients (NOP = 1092; OP = 461). The Mean (SD) age was 39 (17.0) years, 31% of patients were female, and 77% had blunt injuries. Median ISS was 17 [9–25] and 74% had concomitant non-pancreatic intraabdominal injuries. On multivariable analysis, operative management was independently associated with increased odds of 90-day readmissions (aOR = 1.47; p = 0.03), intraabdominal abscesses (aOR = 2.7; p < 0.01), pancreatic pseudocyst (aOR = 2.4; p = 0.04), and need for percutaneous or endoscopic management (aOR = 5.8; p < 0.001).
Conclusion |
Operative management of pancreatic injuries is associated with higher rates of delayed complications compared to non-operative management. Surgically treated pancreatic trauma patients may need close surveillance even after discharge.
Il testo completo di questo articolo è disponibile in PDF.Highlights |
• | Most patients with traumatic pancreatic injury were treated non-operatively. |
• | Operative treatment was associated with longer hospital length of stay and worse outcomes within 90 days post-discharge. |
• | Worse outcomes included unplanned readmissions, abscesses, pancreatic insufficiency, and the need for drainage. |
• | No difference in delayed pancreatitis, sepsis, and 90-day mortality between both groups. |
Mappa
Vol 226 - N° 5
P. 682-687 - novembre 2023 Ritorno al numero
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