Iqbal Corey W, Levy Shauna M, Tsao Kuojen, Petrosyan Mikael, Kane Timothy D, Pontarelli Elizabeth M, Upperman Jeffrey S, Malek Marcus, Burns R Cartland, Hill Sarah, Wulkan Mark L, St Peter Shawn D
The Children's Mercy Hospital, Kansas City, Missouri, USA.
J Laparoendosc Adv Surg Tech A. 2012 Jul-Aug;22(6):595-8. doi: 10.1089/lap.2012.0002. Epub 2012 Jun 12.
Traumatic pancreatic transection is uncommon. The role of laparoscopy in the setting of this injury has not been well described.
Six large-volume pediatric trauma centers contributed patients <18 years of age who underwent a distal pancreatectomy for traumatic pancreatic transection from 2000 to 2010.
Twenty-one patients without another indication for emergency laparotomy underwent a distal pancreatectomy for Grade III pancreatic injuries, of which 7 underwent laparoscopic distal pancreatectomy. Mean (±SD) age was 8.6±4.7 years, and 67% were male. There was no difference in the presence of other injuries between the two groups (43% in each group). Computed tomography revealed a transected pancreas in 85% of the laparoscopic patients and 75% of the open group (P=1.0). Mean operative time was 218±101 minutes with laparoscopy compared with 195±111 minutes with the open procedure (P=.7). Median duration of hospitalization was 6 days (range, 6-18 days) in the laparoscopic group compared with 11 days (range, 5-26 days) in the open group (P=0.3). Postoperative morbidity was not different between the two groups (57% versus 21% for laparoscopic versus open, P=.2).
Laparoscopy is equivalent to open distal pancreatectomy in children with select traumatic pancreatic injuries.
