Luis F Cabrera, General Surgery1, Mauricio Pedraza1, Sebastian Sanchez1, Juliana Ordonez, MD, FACS, General Surgeon2, Paula Lopez1, Felipe Bernal1, Patricia Parra1, Carlos Lopez1, Jean A Pulido1, Daniel Gomez, MD, FACS2. 1Bosque University, 2New Granada Military University
Introduction: An emergency pancreatoduodenectomy is a surgery that is currently used for the management of severe pancreatoduodenal trauma after damage control surgery.
Objectives: To show the experience of pancreatoduodenal trauma management with emergency pancreatoduodenectomy and damage control.
Materials and Methods: We carried a retrospective observational study of a series of cases with severe pancreatoduodenal trauma and reviewed articles published in journals indexed in PubMed and ScienceDirect databases in the last 10 years. We completed the search with the review of classic articles on the subject and compared our experience with those reported in the world medical literature.
Results: In a period of 6 years, 4 patients with severe pancreatoduodenal trauma with injuries due to firearm projectile were obtained, of which 75% were men, with an average age of 17.5 years, with an average ISS score of 39.5 points and associated vascular trauma in 100% of cases. In the 4 cases, damage control and emergency pancreatoduodenectomy were performed and in a second surgical time the gastrointestinal tract reconstruction was carried out. A 75% incidence of surgical site infection were reported, 25% health care associated pneumonia and 50% postoperative pancreatic fistula. With an average stay in the intensive care unit of 12.25 days, average hospital stay of 29.5 days and no mortality.
Conclusions: We evidenced that the resection after the damage control surgery in pancreatoduodenal trauma is effective for the management of this entity, although its accomplishment is a surgical challenge, it is a very useful procedure in the trauma surgery.
Keywords: pancreas; duodenum; abdominal trauma; penetrating injuries; pancreaticoduodenectomy.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 93807
Program Number: P629
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster