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

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dc.contributor.advisorKrige, J E Jen_ZA
dc.contributor.authorThomson, David Alexanderen_ZA
dc.date.accessioned2015-10-25T17:05:31Z
dc.date.available2015-10-25T17:05:31Z
dc.date.issued2012en_ZA
dc.description.abstractBackground: 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.identifier.apacitationThomson, D. A. (2012). <i>The role of endoscopic retrograde pancreatography in the management of pancreatic trauma</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Department of Surgery. Retrieved from http://hdl.handle.net/11427/14312en_ZA
dc.identifier.chicagocitationThomson, David Alexander. <i>"The role of endoscopic retrograde pancreatography in the management of pancreatic trauma."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Department of Surgery, 2012. http://hdl.handle.net/11427/14312en_ZA
dc.identifier.citationThomson, D. 2012. The role of endoscopic retrograde pancreatography in the management of pancreatic trauma. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Thomson, David Alexander AB - 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. DA - 2012 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2012 T1 - The role of endoscopic retrograde pancreatography in the management of pancreatic trauma TI - The role of endoscopic retrograde pancreatography in the management of pancreatic trauma UR - http://hdl.handle.net/11427/14312 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/14312
dc.identifier.vancouvercitationThomson DA. The role of endoscopic retrograde pancreatography in the management of pancreatic trauma. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Department of Surgery, 2012 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/14312en_ZA
dc.language.isoengen_ZA
dc.publisher.departmentDepartment of Surgeryen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.subject.otherSurgeryen_ZA
dc.subject.otherPancreatic Traumaen_ZA
dc.titleThe role of endoscopic retrograde pancreatography in the management of pancreatic traumaen_ZA
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMMeden_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceThesisen_ZA
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