Application of Emergency Pancreaticoduodenectomy in the Treatment of Blunt Duodenal and Pancreatic Trauma

Fan NI; Zheng-cheng YE; Zhi-tang GUO; Ying-nan LI; Guang ZHAI; Chao ZHONG; Ke-jia LI; Xiao-xing CHEN; Dong WEI; Xue-song WU; Ren-chao ZOU; Jia-yun GE

doi:10.12259/j.issn.2095-610X.S20201108

Volume 41 Issue 11

Dec. 2020

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Article Navigation > Journal of Kunming Medical University > 2020 > 41(11): 88-92

Fan NI, Zheng-cheng YE, Zhi-tang GUO, Ying-nan LI, Guang ZHAI, Chao ZHONG, Ke-jia LI, Xiao-xing CHEN, Dong WEI, Xue-song WU, Ren-chao ZOU, Jia-yun GE. Application of Emergency Pancreaticoduodenectomy in the Treatment of Blunt Duodenal and Pancreatic Trauma[J]. Journal of Kunming Medical University, 2020, 41(11): 88-92. doi: 10.12259/j.issn.2095-610X.S20201108

Citation:

Fan NI, Zheng-cheng YE, Zhi-tang GUO, Ying-nan LI, Guang ZHAI, Chao ZHONG, Ke-jia LI, Xiao-xing CHEN, Dong WEI, Xue-song WU, Ren-chao ZOU, Jia-yun GE. Application of Emergency Pancreaticoduodenectomy in the Treatment of Blunt Duodenal and Pancreatic Trauma[J]. Journal of Kunming Medical University, 2020, 41(11): 88-92. doi: 10.12259/j.issn.2095-610X.S20201108

Citation:

Fan NI, Zheng-cheng YE, Zhi-tang GUO, Ying-nan LI, Guang ZHAI, Chao ZHONG, Ke-jia LI, Xiao-xing CHEN, Dong WEI, Xue-song WU, Ren-chao ZOU, Jia-yun GE. Application of Emergency Pancreaticoduodenectomy in the Treatment of Blunt Duodenal and Pancreatic Trauma[J]. Journal of Kunming Medical University, 2020, 41(11): 88-92. doi: 10.12259/j.issn.2095-610X.S20201108

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Application of Emergency Pancreaticoduodenectomy in the Treatment of Blunt Duodenal and Pancreatic Trauma

doi: 10.12259/j.issn.2095-610X.S20201108

1.
Dept. of Hepatobiliary Surgery, The Sixth Affiliated Hospital of Kunming Medical University, Yuxi Yunan 653100
2.
Dept. of Hepato-pancreato-biliary Surgery, The 2nd Affiliated Hospital of Kunming Medical University, Kunming Yunnan 650101, China

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Corresponding author: Ge jiayun, Email: adonis1125@163.com
Received Date: 2020-09-03
Available Online: 2020-12-03
Publish Date: 2020-11-25

Abstract

Abstract

Objective To evaluate the value of emergency pancreaticoduodenectomy in the treatment of blunt duodenal and pancreatic head trauma. Methods Twenty one patients's clinical data who were treated in the second affiliated hospital of Kunming Medical University during January 2018 to January 2020 due to blunt duodenal and pancreatic trauma is retrospectively analyzed. Five patients underwent EPD: 4 males and 1 female; The rest of the patients without emergency pancreatoduodenectomy were non-EPD group, there are 16 cases: 13 males and 3 females. Two groups were compared in terms of average age, average operation time, average intraoperative blood loss, postoperative complications, mortality, average hospital stay and other indicators. Results In the EPD group, the average age was 28.60±5.18 years, the average operative time was 270.00±47.43 minutes, the intraoperative blood loss was 450.00±165.83 ml, the average length of hospitalization was 15.00±4.85 days, there was 1 case of postoperative pancreatic fistula, 1 case of localized effusion, and no postoperative death. In the non-EPD group: the average age was 40.81±12.48 years; the average operative time was 266.88±96.73 minutes; the intraoperative blood loss was 695.63±399.02; the average length of hospital stay was 53.19±27.58 days. There were 11 cases of postoperative pancreatic fistula, 5 cases of bile fistula, 6 cases of intestinal fistula, 12 cases of infection, 9 cases of localized effusion and 3 cases of postoperative death. The average age in the EPD group was significantly lower than in the non-EPD group（P < 0.05）. The average hospital stay and the incidence of postoperative infection complications in the emergency pancreaticoduodenal surgery group were significantly lower than in the non-EPD group（P < 0.05）. 16 patients were followed up in outpatient clinics for 3-24 months, and the average follow-up time was 11.64±5.57 months. EPD group didn't have any postoperative complications. In the non EPD group, 3 patients recovered after gastrojejunostomy due to duodenal stenosis from 1 to 5 months after discharge, and 1 patient improved after endoscopic plastic stent implantation due to benign biliary stricture 7 months after discharge. Conclusions EPD is safe and feasible for the patients with blunt duodenal and pancreatic head trauma, especially for who have been injured for less than 24 hours and whose abdominal infection has not widespread. In this case, Chen's pancreaticoduodenal anastomosis is an important guarantee for successful surgery.
- Blunt trauma,
- Emergency,
- Pancreaticoduodenectomy,
- Chen's pancreaticoduodenal anastomosis

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References(15)

References

[1]	Søreide K,Weiser T G,Parks R W. Clinical update on management of pancreatic trauma[J]. HPB (Oxford),2018,20(12):1099-1108. doi: 10.1016/j.hpb.2018.05.009
[2]	丁威威,王凯,刘宝晨,习丰产,汪志明,李维勤,黎介寿. 胰腺外伤单中心136例诊治报告[J].中国实用外科杂志,2018,38(07):782-785.
[3]	陈孝平. 陈氏贯穿胰腺连续缝合法行肠壁内翻套入式胰肠吻合术的几点体会[J].腹部外科,2019,32(2):77-79. doi: 10.3969/j.issn.1003-5591.2019.02.001
[4]	Moore E E,Cogbill T H,Malangoni M A. Organ injury scaling,Ⅱ:Pancreas,duodenum,small bowel,colon,and rectum[J]. The Journal of Trauma,1990,30(11):1427-1429. doi: 10.1097/00005373-199011000-00035
[5]	任华建,王革非,顾国胜,等. 腹部创伤后急诊胰十二指肠切除手术的预后分析[J].创伤外科杂志,2017,19(12):892-896. doi: 10.3969/j.issn.1009-4237.2017.12.004
[6]	Thompson Callie M,Shalhub Sherene,DeBoard Zachary M. Revisiting the pancreaticoduodenectomy for trauma[J]. Journal of Trauma & Acute Care Surgery,2013,75(2):225-228. doi: 10.1097/ta.0b013e31829a0aaf
[7]	李海良,胡铭荣. 闭合性十二指肠破裂25例诊治分析[J].中华危重症医学杂志(电子版),2015,2(3):186-188.
[8]	杨文博,李乐,陈华,等. 闭合性胰腺损伤的临床诊治分析[J].中华外科杂志,2019,57(9):660-665. doi: 10.3760/cma.j.issn.0529-5815.2019.09.004
[9]	Ho V P,Patel N J,Bokhari F. Management of adult pancreatic injuries:A practice management guideline from the Eastern Association for the Surgery of Trauma[J]. Journal of Trauma & Acute Care Surgery,2016,82(1):185. doi: 10.1097/TA.0000000000001300
[10]	Toshio M,Osamu T,Teruo S. Long-term outcomes of pancreatic function following pancreatic trauma[J]. The Kurume Medical Journal,2016,63(3.4):53-60. doi: 10.2739/kurumemedj.MS00001
[11]	颜晨,江勇,吴宝强,等. 闭合性胰腺合并十二指肠损伤的急诊胰十二指肠切除术4例[J].肝胆胰外科杂志,2015,27(1):56-57. doi: 10.11952/j.issn.1007-1954.2015.01.017
[12]	胡少辉,周伟,晏华军. 十二指肠损伤17例临床诊治分析[J].中国现代普通外科进展,2018,21(2):120-121.
[13]	Mario Kopljar,Stjepan Ivandić,Marko Mesić,et al. Operative versus non-operative management of blunt pancreatic trauma in children: Systematic review and meta-analysis[J]. Injury,2020,2(35):1-9. doi: 10.1097/TA.0000000000001224
[14]	BjoRnsson B,Kullman E,Gasslander T. Early endoscopic treatment of blunt traumatic pancreatic injury[J]. Scandinavian Journal of Gastroenterology,2015,50(12):1-9. doi: 10.3109/00365521.2015.1060627
[15]	张海洋,钱国武,宋展. 胰腺中段切除术与3 cm胰腺支架ERCP术对交通事故致胰腺损伤干预研究[J].创伤外科杂志,2019,21(9):675-677. doi: 10.3969/j.issn.1009-4237.2019.09.009

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