The role of endoscopic retrograde pancreatography in the management of pancreatic trauma

 

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dc.contributor.advisor Krige, J E J en_ZA
dc.contributor.author Thomson, David Alexander en_ZA
dc.date.accessioned 2015-10-25T17:05:31Z
dc.date.available 2015-10-25T17:05:31Z
dc.date.issued 2012 en_ZA
dc.identifier.citation Thomson, D. 2012. The role of endoscopic retrograde pancreatography in the management of pancreatic trauma. University of Cape Town. en_ZA
dc.identifier.uri http://hdl.handle.net/11427/14312
dc.description.abstract Background: Endoscopic retrograde pancreatography (ERP) has various applications in the diagnosis and management of pancreatic trauma. The utility of ERP in pancreatic trauma presenting to a level 1 equivalent trauma centre was analysed. Methods: Patients who sustained pancreatic trauma and underwent ERP were identified. Patient demographics, mechanism of injury, time to presentation, diagnostic modalities, associated injuries, clinical management, endoscopic interventions and their timing, surgical treatment and patient outcomes were recorded. Results: Forty-eight patients with pancreatic trauma were referred for ERP after blunt (26), gunshot (15), or stab (7) injury. The average time from injury to ERP was 38 days (range 2 – 365). An ERP visualized the duct in 47 patients. Twenty-four patients had a pancreatic fistula, 12 patients had a main pancreatic duct stricture or cut-off and 10 patients had a pseudocyst. Endoscopic interventions were pancreatic duct sphincterotomy (15), pancreatic duct stent (7) or pseudocyst drainage (6). Ten patients demonstrated minor injuries and no interventions were performed. One patient had a normal pancreatogram. Ten patients required pancreatic surgery following ERP (distal pancreatectomy n=6, pancreaticojejenostomy n=3 and cystjejenostomy n=1). One patient unable to tolerate ERP had a distal pancreatectomy. Conclusion: The majority of ERPs were performed post surgery or after a delayed presentation. Diagnostic success was high and in conjunction with therapeutic interventions 77% of patients avoided surgery for their pancreatic complications. ERP is an effective tool in the delayed management of the local complications of pancreatic trauma. en_ZA
dc.language.iso eng en_ZA
dc.subject.other Surgery en_ZA
dc.subject.other Pancreatic Trauma en_ZA
dc.title The role of endoscopic retrograde pancreatography in the management of pancreatic trauma en_ZA
dc.type Thesis / Dissertation en_ZA
uct.type.publication Research en_ZA
uct.type.resource Thesis en_ZA
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Department of Surgery en_ZA
dc.type.qualificationlevel Masters en_ZA
dc.type.qualificationname MMed en_ZA
uct.type.filetype Text
uct.type.filetype Image


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