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Volume 7, Issue 7 (Suppl) J Gastrointest Dig Syst
ISSN: 2161-069X JGDS, an open access journal Gastroenterologists 2017
December 14-15, 2017
December 14-15, 2017 Dubai, UAE
11th World
Gastroenterologists Summit
Role of endotherapy vs. surgery in the management of traumatic pancreatic injury: A tertiary center
experience
Thinakarmani1, Ratnakar Kini1, Bharat Narasimhan2, Venkateswaran A R1, Kani Sheikh 1, Prem Kumar1, Rajkumar Solomon1, Malar Vizhi1, Thangavelu
Pugazhendhi1, Mohammed Ali1, Sibithooran1, Radhakrishnan1, Mohammed Noufal1
1Institute of Medical Gastroenterology, Madras Medical College, India
2Department of Internal Medicine, KMC Mangalore, Manipal University, Karnataka, India
Background & Aims: Pancreatic injury remains a complicated condition requiring an individualized case by case approach to
management. In this study, we aim to analyze the varied presentations and treatment outcomes of traumatic pancreatic injury
in a tertiary care center.
Materials & Methods: All consecutive patients hospitalized at our center with traumatic pancreatic injury between 2013 and
2017 were included. The American Association for Surgery of Trauma (AAST) classification was used to stratify patients into
five grades of severity. Outcome parameters were then analyzed based on the treatment modality employed.
Results: Of the 35 patients analyzed, 26 had an underlying blunt trauma with the remaining 9 presenting due to penetrating
injury. Overall in-hospital mortality was 28%. 19 of these patients underwent exploratory laparotomy with the remaining 16
managed non-operatively. 9 patients had severe injury (>grade 3); of which 4 underwent endotherapy, 3 had stents placed
and one underwent an endoscopic pseudocyst drainage. Among those managed non-operatively, 3 underwent a radiological
drainage procedure.
Conclusion: Mortality rates were clearly higher in patients managed operatively. This is likely a result of significantly higher
degrees of major associated non-pancreatic injuries and not just a reflection of surgical morbidity. Despite this, surgical
management remains the mainstay of therapy, especially in higher grades of pancreatic injury. However, we would like to
emphasize that endoscopic intervention remains the preferred treatment modality when the clinical setting permits. This is
especially applicable in cases of main pancreatic duct injury with ascites as well as pseudocysts.
Biography
Thinakar Mani has completed his MBBS from Pondicherry University and MD Internal Medicine from Manipal University. Currently, he is working as a Senior
Resident at Institute of Medical Gastroenterology at Madras Medical College, India. He has presented many papers at national conferences all around India.
Thinakar Mani et al., J Gastrointest Dig Syst 2017, 7:7 (Suppl)
DOI: 10.4172/2161-069X-C1-061