The prognostic analysis of emergency pancreaticoduodenectomy due to abdominal trauma

Author(s):
Huajian Ren; Gefei Wang; Jianan Ren

Background:

Emergency pancreatoduodenectomy (EPD) is a complicated surgical procedures for severe pancreatoduodenal injuries, accompanied with high incidence of complications and mortality.

Hypothesis:

To explore the prognosis of EPD due to abdominal trauma.

Methods:

Clinical data of seventeen patients admitted in Jinling Hospital between August 2012 and January 2017 with EPD due to abdominal trauma were retrospectively analyized.

Results:

All the cases admitted were preformed EPD in other hospitals due to trauma, then transferred to our institute for postoperative complications. 11 patients survived and 6 patients died after therapy, the mean length of hospital stay was 112.6 days. All the patients suffered various degree of gastrointestinal fistulae and intra-abdominal infections, including 14 cases of hemorrhage of digestive tract or abdominal cavity(82.4%), 10 cases of pancreatic fistulae(58.8%), 10 cases of enteric fistulae(58.8%), 9 cases of biliary fistulae(52.9%), 8 cases of Gastrointestinal anastomotic leakage(47.1%) and 8 cases of colonic fistulae(47.1%). The grade of pancreas injuries、blood transfusion and incidence of pancreatic fistulae in death group were significantly higher than those of survival group, p<0.05.

Conclusions:

The postoperative mortality and occurrence of complications of EPD due to abdominal trauma were markedly elevated, and the approach of damage control surgery should be applicated in the procedure of management.