World Journal of Emergency Surgery (Dec 2019)
Duodeno-pancreatic and extrahepatic biliary tree trauma: WSES-AAST guidelines
- Federico Coccolini,
- Leslie Kobayashi,
- Yoram Kluger,
- Ernest E. Moore,
- Luca Ansaloni,
- Walt Biffl,
- Ari Leppaniemi,
- Goran Augustin,
- Viktor Reva,
- Imitiaz Wani,
- Andrew Kirkpatrick,
- Fikri Abu-Zidan,
- Enrico Cicuttin,
- Gustavo Pereira Fraga,
- Carlos Ordonez,
- Emmanuil Pikoulis,
- Maria Grazia Sibilla,
- Ron Maier,
- Yosuke Matsumura,
- Peter T. Masiakos,
- Vladimir Khokha,
- Alain Chichom Mefire,
- Rao Ivatury,
- Francesco Favi,
- Vassil Manchev,
- Massimo Sartelli,
- Fernando Machado,
- Junichi Matsumoto,
- Massimo Chiarugi,
- Catherine Arvieux,
- Fausto Catena,
- Raul Coimbra,
- WSES-AAST Expert Panel
Affiliations
- Federico Coccolini
- General, Emergency and Trauma Surgery Department, Pisa University Hospital
- Leslie Kobayashi
- Division of Trauma, Surgical Critical Care, Burns and Acute Care Surgery, University of California San Diego
- Yoram Kluger
- Division of General Surgery, Rambam Health Care Campus
- Ernest E. Moore
- Trauma Surgery, Denver Health
- Luca Ansaloni
- General, Emergency and Trauma Surgery Department, Bufalini Hospital
- Walt Biffl
- Trauma Surgery Department, Scripps Memorial Hospital
- Ari Leppaniemi
- General Surgery Department, Mehilati Hospital
- Goran Augustin
- Department of Surgery, Zagreb University Hospital Centre and School of Medicine, University of Zagreb
- Viktor Reva
- General and Emergency Surgery, Sergei Kirov Military Academy
- Imitiaz Wani
- Department of Surgery, DHS Hospitals
- Andrew Kirkpatrick
- General, Acute Care, Abdominal Wall Reconstruction, and Trauma Surgery, Foothills Medical Centre
- Fikri Abu-Zidan
- Department of Surgery, College of Medicine and Health Sciences, UAE University
- Enrico Cicuttin
- General, Emergency and Trauma Surgery Department, Bufalini Hospital
- Gustavo Pereira Fraga
- Trauma/Acute Care Surgery & Surgical Critical Care, University of Campinas
- Carlos Ordonez
- Trauma and Acute Care Surgery, Fundacion Valle del Lili
- Emmanuil Pikoulis
- 3rd Department of Surgery, Attiko Hospital, National & Kapodistrian University of Athens
- Maria Grazia Sibilla
- General, Emergency and Trauma Surgery Department, Bufalini Hospital
- Ron Maier
- Department of Surgery, Harborview Medical Centre
- Yosuke Matsumura
- Department of Emergency and Critical Care Medicine, Chiba University Hospital
- Peter T. Masiakos
- Pediatric Trauma Service, Massachusetts General Hospital
- Vladimir Khokha
- General Surgery Department, Mozir City Hospital
- Alain Chichom Mefire
- Department of Surgery and Obstetrics and Gynecology, University of Buea
- Rao Ivatury
- General and Trauma Surgery, Virginia Commonwealth University
- Francesco Favi
- General, Emergency and Trauma Surgery Department, Bufalini Hospital
- Vassil Manchev
- General and Trauma Surgery Department, Pietermaritzburg Hospital
- Massimo Sartelli
- General and Emergency Surgery, Macerata Hospital
- Fernando Machado
- General and Emergency Surgery Department, Montevideo Hospital
- Junichi Matsumoto
- Department of Emergency and Critical Care Medicine, Saint-Marianna University School of Medicine
- Massimo Chiarugi
- General, Emergency and Trauma Surgery Department, Pisa University Hospital
- Catherine Arvieux
- Clin. Univ. de Chirurgie Digestive et de l’Urgence, CHUGA-CHU Grenoble Alpes, UGA-Université Grenoble Alpes
- Fausto Catena
- Emergency and Trauma Surgery, Maggiore Hospital
- Raul Coimbra
- Department of General Surgery, Riverside University Health System Medical Center
- WSES-AAST Expert Panel
- DOI
- https://doi.org/10.1186/s13017-019-0278-6
- Journal volume & issue
-
Vol. 14,
no. 1
pp. 1 – 23
Abstract
Abstract Duodeno-pancreatic and extrahepatic biliary tree injuries are rare in both adult and pediatric trauma patients, and due to their anatomical location, associated injuries are very common. Mortality is primarily related to associated injuries, but morbidity remains high even in isolated injuries. Optimal management of duodeno-bilio-pancreatic injuries is dictated primarily by hemodynamic stability, clinical presentation, and grade of injury. Endoscopic and percutaneous interventions have increased the ability to non-operatively manage these injuries. Late diagnosis and treatment are both associated to increased morbidity and mortality. Sequelae of late presentations of pancreatic injury and complications of severe pancreatic trauma are also increasingly addressed endoscopically and with interventional radiology procedures. However, for moderate and severe extrahepatic biliary and severe duodeno-pancreatic injuries, immediate operative intervention is preferred as associated injuries are frequent and commonly present with hemodynamic instability or peritonitis. The aim of this paper is to present the World Society of Emergency Surgery (WSES) and American Association for the Surgery of Trauma (AAST) duodenal, pancreatic, and extrahepatic biliary tree trauma management guidelines.
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