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The role of endoscopic retrograde pancreatography in the management of pancreatic trauma
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 underwen...
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| Format: | Thesis |
| Language: | English |
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Department of Surgery
2015
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| _version_ | 1867613312458424320 |
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| access_status_str | Open Access |
| author | Thomson, David Alexander |
| author2 | Krige, J E J |
| author_browse | Krige, J E J Thomson, David Alexander |
| author_facet | Krige, J E J Thomson, David Alexander |
| author_sort | Thomson, David Alexander |
| collection | Thesis |
| description | 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. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/14312 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:34:08.683Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2015 |
| publishDateRange | 2015 |
| publishDateSort | 2015 |
| publisher | Department of Surgery |
| publisherStr | Department of Surgery |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/14312 The role of endoscopic retrograde pancreatography in the management of pancreatic trauma Thomson, David Alexander Krige, J E J Surgery Pancreatic Trauma 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. 2015-10-25T17:05:31Z 2015-10-25T17:05:31Z 2012 Master Thesis Masters MMed http://hdl.handle.net/11427/14312 eng application/pdf Department of Surgery Faculty of Health Sciences University of Cape Town |
| spellingShingle | Surgery Pancreatic Trauma Thomson, David Alexander The role of endoscopic retrograde pancreatography in the management of pancreatic trauma |
| thesis_degree_str | Master's |
| title | The role of endoscopic retrograde pancreatography in the management of pancreatic trauma |
| title_full | The role of endoscopic retrograde pancreatography in the management of pancreatic trauma |
| title_fullStr | The role of endoscopic retrograde pancreatography in the management of pancreatic trauma |
| title_full_unstemmed | The role of endoscopic retrograde pancreatography in the management of pancreatic trauma |
| title_short | The role of endoscopic retrograde pancreatography in the management of pancreatic trauma |
| title_sort | role of endoscopic retrograde pancreatography in the management of pancreatic trauma |
| topic | Surgery Pancreatic Trauma |
| url | http://hdl.handle.net/11427/14312 |
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