Diagnostic and therapeutic role of endoscopic retrograde pancreatography in the management of traumatic pancreatic duct injury patients: Single center experience for 34 years

Kim, Seongyup; Kim, Jae Woo; Jung, Pil Young; Kwon, Ha Yan; Shim, Hongjin; Jang, Ji Young; Bae, Keum Seok

doi:10.1016/j.ijsu.2017.03.054

Cited by 38 publications

(46 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…10 Notably, data are based on case series with variable outcome, but endoscopic management has gained both popularity and success, even for main duct disruptions. 10,27,[66][67][68][69][70] Specific endoscopy-based scoring systems for pancreatic duct disruption after blunt trauma have been proposed in a small series from Kanagawa, Japan 71 and a later modified version from Cape Town, South Africa. 67 These scores are quite detailed, with 4-5 categories and several subcategories, thus questioning the robustness of each subcategory.…”

Section: Endoscopic Managementmentioning

confidence: 99%

Clinical update on management of pancreatic trauma

Søreide

Weiser

Parks

2018

HPB

View full text Add to dashboard Cite

show abstract

Section: Endoscopic Managementmentioning

confidence: 99%

Clinical update on management of pancreatic trauma

Søreide

Weiser

Parks

2018

HPB

View full text Add to dashboard Cite

show abstract

“…A total of 37 studies were included. 1,4,6 -40 There were 34 published journal articles, 2 conference abstracts, and 1 published conference presentation. In 21 of the studies, imaging of PI was the primary objective.…”

Section: Resultsmentioning

confidence: 99%

Imaging of Blunt Pancreatic Trauma: A Systematic Review

2020

View full text Add to dashboard Cite

Purpose: Despite several published reports on the value of imaging in acute blunt pancreatic trauma, there remains a large variability in the reported performance of ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI). The purpose of this study is to present a systematic review on the utility of these imaging modalities in the acute assessment of blunt pancreatic trauma. In addition, a brief overview of the various signs of pancreatic trauma will be presented. Methods: Keyword search was performed in MEDLINE, EMBASE, and Web of Science databases for relevant studies in the last 20 years (1999 onward). Titles and abstracts were screened, followed by full-text screening. Inclusion criteria were defined as studies reporting on the effectiveness of imaging modality (US, CT, or MRI) in detecting blunt pancreatic trauma. Results: After initial search of 743 studies, a total of 37 studies were included in the final summary. Thirty-six studies were retrospective in nature. Pancreatic injury was the primary study objective in 21 studies. Relevant study population varied from 5 to 299. Seventeen studies compared the imaging findings against intraoperative findings. Seven studies performed separate analysis for pancreatic ductal injuries and 9 studies only investigated ductal injuries. The reported sensitivities for the detection of pancreatic injuries at CT ranged from 33% to 100% and specificity ranged from 62% to 100%. Sensitivity at US ranged from 27% to 96%. The sensitivity at MRI was only reported in 1 study and was 92%. Conclusion: There remains a large heterogeneity among reported studies in the accuracy of initial imaging modalities for blunt pancreatic injury. Although technological advances in imaging equipment would be expected to improve accuracy, the current body of literature remains largely divided. There is a need for future studies utilizing the most advanced imaging equipment with appropriately defined gold standards and outcome measures.

show abstract

“…When deep parenchymal injury is present (AAST-OIS grade ≥II and JAST type III), enhanced CT is insufficient for accurate identification of pancreatic duct injury [10] . If ductal injury is suspected, ERCP should be planned [4], [15], [16] . Magnetic resonance cholangiopancreatography is also available to confirm the continuity of the pancreatic duct; however, it is not able to detect leakage from the pancreatic duct.…”

Section: Discussion and Proposal For Algorithm For Management Of Pancmentioning

confidence: 99%

Pancreatic Trauma: Proposal for Management Algorithm

Hashimoto

Yamamoto

Yamaki

et al. 2020

International Surgery

View full text Add to dashboard Cite

IntroductionPancreatic trauma is potentially lethal despite recent improvements in surgical techniques and conservative management. However, no guidelines for the management of pancreatic trauma have been established. In this report, we propose an algorithm for the management of pancreatic trauma based on our experience of nine cases and a literature review.Case presentationThis study included nine patients with pancreatic trauma (five men and four women). The patients’ median age was 40 years (range, 17–75 years). The overall mortality rate was 22.2%, and the postoperative mortality rate was 16.7%. Superficial trauma was present in two patients. Deep trauma without injury to the main pancreatic duct was present in one patient, and this patient was treated successfully with endoscopic nasopancreatic drainage. Active bleeding was present in two patients and controlled by interventional radiology. Deep trauma with injury to the main pancreatic duct was present in six patients. Among them, one patient died after conservative treatment with endoscopic nasopancreatic drainage. The other five patients underwent surgery (pancreatic resection in four and necrosectomy in one).ConclusionThe herein-described algorithm recommends interventional radiology for active arterial bleeding, conservative management for trauma without ductal injury, and surgery for trauma with ductal injury. This algorithm may provide a basis for future establishment of guidelines.

show abstract

Diagnostic and therapeutic role of endoscopic retrograde pancreatography in the management of traumatic pancreatic duct injury patients: Single center experience for 34 years

Cited by 38 publications

References 27 publications

Clinical update on management of pancreatic trauma

Clinical update on management of pancreatic trauma

Imaging of Blunt Pancreatic Trauma: A Systematic Review

Pancreatic Trauma: Proposal for Management Algorithm

Contact Info

Product

Resources

About