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Operative management of pancreatic injuries is correlated with higher rates of delayed complications compared to non-operative approaches, suggesting that patients undergoing surgical treatment for pancreatic trauma require vigilant post-discharge surveillance.

The following is a summary of “From surveillance to surgery: The delayed implications of non-operative and operative management of pancreatic injuries,” published in the NOVEMBER 2023 issue of Surgery by Alizai, et al.

For a study, researchers sought to compare the delayed outcomes between operative and nonoperative management of pancreatic injuries, utilizing data from the 2017 Nationwide Readmissions Database on adult trauma patients.

The analysis focused on trauma patients aged 18 years or older with pancreatic injuries, excluding those who died during the index admission. The patients were categorized into two groups: operative (OP) and non-operative (NOP). Comparative outcomes analyses within 90 days post-discharge were conducted, considering age, gender, injury type, Injury Severity Score (ISS), and concomitant intraabdominal injuries. Multivariable regression analyses were employed for a comprehensive assessment.

The study identified 1,553 patients, with 1,092 in the NOP group and 461 in the OP group. The mean age was 39 years, with 31% female patients and 77% experiencing blunt injuries. The median ISS was 17, and 74% had concomitant non-pancreatic intraabdominal injuries. Multivariable analysis revealed that operative management was independently associated with increased odds of 90-day readmissions (adjusted odds ratio [aOR] = 1.47; P = 0.03), intraabdominal abscesses (aOR = 2.7; P < 0.01), pancreatic pseudocyst (aOR = 2.4; P = 0.04), and the necessity for percutaneous or endoscopic management (aOR = 5.8; P < 0.001).

Operative management of pancreatic injuries is correlated with higher rates of delayed complications compared to non-operative approaches. It suggested that patients undergoing surgical treatment for pancreatic trauma may require vigilant post-discharge surveillance.

Source: americanjournalofsurgery.com/article/S0002-9610(23)00341-0/fulltext