Clinical characteristics and long-term outcomes following pancreatic injury – An international multicenter cohort study

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Clinical characteristics and long-term outcomes following pancreatic injury – An international multicenter cohort study

Meijer, Laura L. (author): Department of Surgery, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands,Vrije Univ Amsterdam, Netherlands

Vaalavuo, Yrjö (author): Department of Gastroenterology and Alimentary Tract Surgery, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland,Tampere Univ, Finland

Regnér, Sara (author): Lund University,Lunds universitet,Kirurgi,Forskargrupper vid Lunds universitet,Surgery,Lund University Research Groups,Department of Surgery, Institution of Clinical Sciences Malmö, Skåne University Hospital, Lund University, Lund, Sweden,Lund Univ, Sweden

Sallinen, Ville (author): Transplantation and Liver Surgery, University of Helsinki and Helsinki University Hospital, Finland; Gastroenterological Surgery, University of Helsinki and Helsinki University Hospital, Finland,Univ Helsinki, Finland; Helsinki Univ Hosp, Finland

Lemma, Aurora (author): Gastroenterological Surgery, University of Helsinki and Helsinki University Hospital, Finland,Helsinki Univ Hosp, Finland; Univ Helsinki, Finland

Arnelo, Urban (author): Department of Upper Gastrointestinal Diseases, Karolinska University Hospital and CLINTEC, Karolinska Institutet, Sweden and Department of Surgical and Perioperative Sciences/Surgery, Umeå University, Stockholm, Umeå, Sweden,Karolinska Inst, Sweden; Umea Univ, Sweden

Valente, Roberto (author): Department of Upper Gastrointestinal Diseases, Karolinska University Hospital and CLINTEC, Karolinska Institutet, Sweden and Department of Surgical and Perioperative Sciences/Surgery, Umeå University, Stockholm, Umeå, Sweden,Karolinska Inst, Sweden; Umea Univ, Sweden

Westermark, Sofia (author): Umeå universitet,Umeå University,Umea Univ, Sweden,Kirurgi

An, David (author): Linköpings universitet,Linköping University,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Department of Surgery, Linköping University and Department of Surgery, Vasterviks Sjukhus, Vastervik, Sweden

Moir, John A.G. (author): Department of HPB and Transplant Surgery, Freeman Hospital, Newcastle Upon Tyne, United Kingdom,Freeman Rd Hosp, England

Irwin, Ellen A. (author): Department of HPB and Transplant Surgery, Freeman Hospital, Newcastle Upon Tyne, United Kingdom,Freeman Rd Hosp, England

Biesel, Esther A. (author): Center of Surgery, Department of General and Visceral Surgery, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany,Univ Freiburg, Germany

Hopt, Ulrich T. (author): Center of Surgery, Department of General and Visceral Surgery, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany,Univ Freiburg, Germany

Fichtner-Feigl, Stefan (author): Center of Surgery, Department of General and Visceral Surgery, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany,Univ Freiburg, Germany

Wittel, Uwe A. (author): Center of Surgery, Department of General and Visceral Surgery, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany,Univ Freiburg, Germany

Weniger, Maximilian (author): Department of General, Visceral and Transplantation Surgery, Ludwig-Maximilians-University, Munich, Germany,Ludwig Maximilians Univ Munchen, Germany

Karle, Henning (author): Department of General, Visceral and Transplantation Surgery, Ludwig-Maximilians-University, Munich, Germany,Ludwig Maximilians Univ Munchen, Germany

Bloemers, Frank W. (author): Department of Trauma Surgery, Amsterdam UMC, Univ(ersity) of Amsterdam, Amsterdam, Netherlands

Sutton, Robert (author): Department of Pancreatic Surgery, Liverpool University Hospitals NHS Foundation Trust and Department of Clinical and Molecular Cancer Medicine, University of Liverpool, Liverpool, United Kingdom,Liverpool Univ Hosp NHS Fdn Trust, England; Univ Liverpool, England

Charnley, Richard M. (author): Department of HPB and Transplant Surgery, Freeman Hospital, Newcastle Upon Tyne, United Kingdom,Freeman Rd Hosp, England

Ruess, Dietrich A. (author): Center of Surgery, Department of General and Visceral Surgery, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany,Univ Freiburg, Germany

Szatmary, Peter (author): Department of Pancreatic Surgery, Liverpool University Hospitals NHS Foundation Trust and Department of Clinical and Molecular Cancer Medicine, University of Liverpool, Liverpool, United Kingdom,Liverpool Univ Hosp NHS Fdn Trust, England; Univ Liverpool, England

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CELL PRESS, 2023
2023
English.
In: Heliyon. - : CELL PRESS. - 2405-8440. ; 9:6

Related links:: http://dx.doi.org/10... (free); show more...; https://doi.org/10.1...; https://umu.diva-por... (primary) (Raw object); https://lup.lub.lu.s...; https://doi.org/10.1...; http://kipublication...; https://urn.kb.se/re...; https://urn.kb.se/re...; show less...

Journal article (peer-reviewed)

Abstract Subject headings

Background: Trauma to the pancreas is rare but associated with significant morbidity. Currently available management guidelines are based on low-quality evidence and data on long-term outcomes is lacking. This study aimed to evaluate clinical characteristics and patient-reported long-term outcomes for pancreatic injury. Methods: A retrospective cohort study evaluating treatment for pancreatic injury in 11 centers across 5 European nations over >10 years was performed. Data relating to pancreatic injury and treatment were collected from hospital records. Patients reported quality of life (QoL), changes to employment and new or ongoing therapy due to index injury. Results: In all, 165 patients were included. The majority were male (70.9%), median age was 27 years (range: 6–93) and mechanism of injury predominantly blunt (87.9%). A quarter of cases were treated conservatively; higher injury severity score (ISS) and American Association for the Surgery of Trauma (AAST) pancreatic injury scores increased the likelihood for surgical, endoscopic and/or radiologic intervention. Isolated, blunt pancreatic injury was associated with younger age and pancreatic duct involvement; this cohort appeared to benefit from non-operative management. In the long term (median follow-up 93; range 8–214 months), exocrine and endocrine pancreatic insufficiency were reported by 9.3% of respondents. Long-term analgesic use also affected 9.3% of respondents, with many reported quality of life problems (QoL) potentially attributable to side-effects of opiate therapy. Overall, impaired QoL correlated with higher ISS scores, surgical therapy and opioid analgesia on discharge. Conclusions: Pancreatic trauma is rare but can lead to substantial short- and long-term morbidity. Near complete recovery of QoL indicators and pancreatic function can occur despite significant injury, especially in isolated, blunt pancreatic injury managed conservatively and when early weaning off opiate analgesia is achieved.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Health Care Service and Management, Health Policy and Services and Health Economy (hsv//eng)

Keyword

Clinical course
Interdisciplinary treatment
Long-term outcomes
Pancreatic trauma
Quality of life
Pancreatic trauma; Clinical course; Interdisciplinary treatment; Long-term outcomes; Quality of life

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art (subject category)
ref (subject category)

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Surgery

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Health Sciences; and Health Care Serv ...

Articles in the publication: Heliyon

By the university: Lund University; Karolinska Institutet; Linköping University; Umeå University

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