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Journal of the Korean Society of Traumatology 2011;24(1):1-6.
Clinical Outcomes and Risk Factors of Traumatic Pancreatic Injuries
Hong Tae Lee, Jae Il Kim, Pyong Wha Choi, Je Hoon Park, Tae Gil Heo, Myung Soo Lee, Chul Nam Kim, Surk Hyo Chang
Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Korea. erythrokim@paik.ac.kr
외상성 췌장 손상의 임상 결과 및 예후인자
이홍태∙김재일∙최평화∙박제훈∙허태길∙이명수∙김철남∙장석효
인제대학교 의과대학 일산백병원 외과학교실
Abstract
PURPOSE
Even though traumatic pancreatic injuries occur in only 0.2% to 4% of all abdominal injuries, the morbidity and the mortality rates associated with pancreatic injuries remain high. The aim of this study was to evaluate the clinical outcomes of traumatic pancreatic injuries and to identify predictors of mortality and morbidity.
METHODS
We retrospectively reviewed the medical records of 26 consecutive patients with a pancreatic injury who underwent a laparotomy from January 2000 to December 2010. The data collected included demographic data, the mechanism of injury, the initial vital signs, the grade of pancreatic injury, the injury severity score (ISS), the revised trauma score (RTS), the Glasgow Coma Scale (GCS), the number of abbreviated injury scales (AIS), the number of associated injuries, the initial laboratory findings, the amount of blood transfusion, the type of operation, the mortality, the morbidity, and others.
RESULTS
The overall mortality rate in our series was 23.0%, and the morbidity rate was 76.9%. Twenty patients (76.9%) had associated injuries to either intra-abdominal organs or extra-abdominal organs. Two patients (7.7%) underwent external drainage, and 18 patients (69.3%) underwent a distal pancreatectomy. Pancreaticoduodenectomies were performed in 6 patients (23.0%). Three patients underwent a re-laparotomy due to anastomosis leakage or postoperative bleeding, and all patients died. The univariate analysis revealed 11 factors (amount of transfusion, AAST grade, re-laparotomy, associated duodenal injury, base excess, APACHE II score, type of operation, operation time, RTS, associated colon injury, GCS) to be significantly associated with mortality (p<0.05).
CONCLUSION
Whenever a surgeon manages a patient with traumatic pancreatic injury, the surgeon needs to consider the predictive risk factors. And, if possible, the patient should undergo a proper and meticulous, less invasive surgical procedure.
Key Words: Pancreatic injuries; Mortality; Morbidity; Risk factors


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