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Management and Outcome of Blunt Pancreatic Trauma: A Retrospective Cohort Study

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Abstract

Background

Pancreatic injury is rare, but it has a high mortality rate and its optimal treatment remains controversial. This study aimed to evaluate the clinical characteristics, management strategies, and outcomes of patients with blunt pancreatic injury.

Methods

This retrospective cohort study was performed on patients with a confirmed blunt pancreatic injury who were admitted to our hospital from March 2008 to December 2020. The clinical characteristics and outcomes of patients receiving different management strategies were compared. The risk factors for in-hospital mortality were evaluated by performing a multivariate regression analysis.

Results

A total of 98 patients diagnosed with blunt pancreatic injury were identified, with 40 patients having undergone nonoperative treatment (NOT) and 58 patients having undergone surgical treatment (ST). The overall in-hospital deaths were 6 (6.1%), including 2 (5.0%) and 4 (6.9%) in the NOT and ST groups, respectively. Pancreatic pseudocysts occurred in 15 (37.5%) and 3 (5.2%) of the NOT and ST groups, respectively, showing a significant difference between the two groups (P < 0.001). In the multivariate regression analysis, concomitant duodenal injury (OR = 14.42, 95% CI 1.27–163.52; P = 0.031) and sepsis (OR = 43.47, 95% CI, 4.15–455.75; P = 0.002) were independently associated with in-hospital mortality.

Conclusions

Except for the higher incidence of pancreatic pseudocysts in the NOT group than in the ST group, there were no significant differences in the other clinical outcomes between the two groups. Concomitant duodenal injury and sepsis were the risk factors for in-hospital mortality.

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Acknowledgements

The authors would like to thank Chunhua Xi, Feng Guo, Jianmin Chen, Junli Wu, Kai Zhang, Lei Jiang, Tewodross Getu Wolde, Wentao Gao, and Zipeng Lu (in alphabetical order) for their substantial support conducting this study.

Funding

This work was supported by grants from National Science Foundation of China (No. 81672449 and No. 81972323).

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Author notes

  1. Xiaozhi Lu and Hao Gao are authors contributed equally.

Authors and Affiliations

  1. Pancreas Center, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China

    Xiaozhi Lu, Hao Gao, Kuirong Jiang, Yi Miao & Jishu Wei

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Contributions

XL and HG contributed equally to this article. JW designed the study. XL and HG collected the data. XL and HG performed the analysis and data interpretation. XL wrote the manuscript. KJ and YM were responsible for and reviewed the manuscript. JW critically revised the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Jishu Wei.

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Conflict of interest

The authors have no conflict of interest to declare.

Ethical approval

This study protocol was approved by the Institutional Review Board of the First Affiliated Hospital of Nanjing Medical University.

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Informed consent was obtained from all individual participants included in the study.

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Lu, X., Gao, H., Jiang, K. et al. Management and Outcome of Blunt Pancreatic Trauma: A Retrospective Cohort Study. World J Surg 47, 2135–2144 (2023). https://doi.org/10.1007/s00268-023-07026-0

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