Management of Traumatic Pancreas Transection

Study Overview
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Brief Summary
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The goal of this observational study is to learn about the type of surgical effect on pancreas transection. The main questions aims to answer are: 1. does pancreas preserving able to decrease incidence of postoperative diabeters 2. what is cause of major cause of postoperative morbidity and mortality in pancreas transection

Detailed Description
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The study design was a retrospective chart review and analysis of Traumatic Pancreas Transection(TPT) patients treated at National Cheng Kung University Hospital. The clinical records, including demographic data, computed tomographic location of pancreas transection with intraoperative confirmation of the pancreatic injury, associated intra-abdominal injuries, interval time between injury and operation, surgical procedure, presence of complication (pancreas and non pancreas related), timing of drain removal, duration of hospital stay and mortality recorded. The secondary end point of morbidity was assessed using the Clavien-Dindo classification. Initial resuscitation was implemented using ATLS guide-lines. Damage-control laparotomy was applied in critically hemodynamic unstable patients. In a relatively stable patient, damage control procedure using TAE to control solid organ ongoing hemorrhage and blood transfusion prior to pancreas and associated gastrointestinal surgery. Depending the surgeon preference, TPT patient underwent open or laparoscopic surgery, either using distal pancreatectomy, with or without splenectomy or pancreas preserving pancreatojejunostomy. Early pancreas surgery is defined as undergoing pancreas reconstructive surgery within 48 hrs. while delayed is considered when beyond 48 hrs. Operative intervention in 42 each patient was individualized based on the surgeon's. Negative suction drain, using Jackson Pratt drain is placed just near proximal pancreas stump. Drain was removed when the amount was less than 50 cc/day with or without drain amylase/lipase level is less than 3 times of normal serum level. Morbidity was documented as systemic, intra-abdominal, or specific complications related directly to the pancreatic injury. Mortality was defined as any cause of death during hospital days. All available postoperative data including blood glucose, Hb1AC, serum and drain amylase lipase level, timing of drain removal, morbidity, hospital stays and mortality was collected and analyzed.

Official Title
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Surgical Management of Traumatic Pancreas Transection

Conditions
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Pancreatectomy

Intervention / Treatment
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* Other: pancreatectomy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Diagnosed to have pancreas injury confirmed to pancreas injury by laparotomy. Exclusion Criteria: negative pancreas injury by laparotomy

Ages Eligible for Study
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Minimum Age: 1 Year
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: pancreatectomy|pancreaserving surgery, using end to side or end to end, pancreaticojejunostomy|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| post opereative diabetes | occurence of diabetes following pancreas resection and pancreas preserving surgery | 6 month | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| post removal drain outcome | pseudocyst and abscess complication following drain removal | 2 week to 4 weeks |