 |
|
Diagnosis and Treatment of Pancreatic InjuriesAn Analysis of Management Principles
David H. Wisner, MD;
Rebekah L. Wold, MD;
Charles F. Frey, MD
Arch Surg. 1990;125(9):1109-1113.
Abstract
| |
• Ninety-one pancreatic injuries, 47 from blunt trauma, were reviewed with respect to management principles stressed in qi previous reviews. The pancreatic complication rate was 25%. Blunt injury was suspected preoperatively in only 30%. Even short-term observation led to morbidity. Operations done more than 6 hours after admission had a higher complication rate (45%) than those done less than 6 hours after admission (18%). Penrose drainage without a sump was not associated with increased complications. Distal pancreatectomy was done 32 times; splenectomy was done in only 18 patients. Individual duct ligation was rarely done and did not result in a high fistula rate. Pancreatic stump oversew with nonabsorbable suture was associated with a higher rate of pancreatic complications than absorbable suture (58% vs 30%). Only 56% of patients receiving distal pancreatectomy required hyperalimentation. Postoperative serum amylase values were not useful, and amylase values from drainage fluid predicted complications only when they were above 100 000 U/L. Details of pancreatic trauma management are less important than early operation in minimizing morbidity.
(Arch Surg. 1990;125:1109-1113)
Author Affiliations
From the Department of Surgery, University of California, Davis.
Footnotes
Accepted for publication April 22, 1990.
Reprint requests to Department of Surgery, School of Medicine, University of California, Davis, 4301 X St, Room 2310, Sacramento, CA 95817 (Dr Wisner).
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Pancreatic trauma
Brooks et al.
Trauma 2003;5:1-8.
ABSTRACT
Visceral Injuries
Wisner and Blaisdell
Arch Surg 1992;127:687-693.
ABSTRACT
|
