Optimal treatments for hepato-pancreato-biliary trauma in severely injured patients: a narrative scoping review.
Can J Surg
; 63(5): E431-E434, 2020.
Article
en En
| MEDLINE
| ID: mdl-33009897
ABSTRACT
SUMMARY:
Hepato-pancreato-biliary (HPB) injuries can be extremely challenging to manage. This scoping review (8438 citations) offers a number of recommendations. If diagnosis and therapy are rapid, patients with major hepatic injuries who present in physiologic extremis have high survival rates despite prolonged hospital stays. Nonoperative management of major liver injuries, as diagnosed using computed tomography, is typically successful. Adjuncts (e.g., angioembolization, laparoscopic washouts, biliary stents) are essential in managing high-grade injuries. Injury to the extrahepatic biliary tree is rare. Cholecystectomy is indicated for all gallbladder trauma. Full-thickness common bile duct injuries require a hepaticojejunostomy, although damage control remains closed suction drainage. Injuries to the pancreatic head often involve concurrent trauma to regional vasculature. Damage control necessitates drainage after stopping hemorrhage. Injury to the left pancreas commonly requires a distal pancreatectomy. Outcomes for high-grade pancreatic and liver injuries are improved by involving an HPB team. Complications are multidisciplinary and should be managed without delay.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Páncreas
/
Sistema Biliar
/
Traumatismos Abdominales
/
Hígado
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Guideline
/
Systematic_reviews
Límite:
Humans
Idioma:
En
Revista:
Can J Surg
Año:
2020
Tipo del documento:
Article