Laparoscopic versus open distal pancreatectomy in the management of traumatic pancreatic disruption.
OBJECTIVE
Traumatic pancreatic transection is uncommon. The role of laparoscopy in the setting of this injury has not been well described.


METHODS
Six large-volume pediatric trauma centers contributed patients <18 years of age who underwent a distal pancreatectomy for traumatic pancreatic transection from 2000 to 2010.


RESULTS
Twenty-one patients without another indication for emergency laparotomy underwent a distal pancreatectomy for Grade III pancreatic injuries, of which 7 underwent laparoscopic distal pancreatectomy. Mean (±SD) age was 8.6±4.7 years, and 67% were male. There was no difference in the presence of other injuries between the two groups (43% in each group). Computed tomography revealed a transected pancreas in 85% of the laparoscopic patients and 75% of the open group (P=1.0). Mean operative time was 218±101 minutes with laparoscopy compared with 195±111 minutes with the open procedure (P=.7). Median duration of hospitalization was 6 days (range, 6-18 days) in the laparoscopic group compared with 11 days (range, 5-26 days) in the open group (P=0.3). Postoperative morbidity was not different between the two groups (57% versus 21% for laparoscopic versus open, P=.2).


CONCLUSIONS
Laparoscopy is equivalent to open distal pancreatectomy in children with select traumatic pancreatic injuries.
The Children's Mercy Hospital, Kansas City, Missouri, USA.
Corey W
CW
Iqbal
Shauna M
SM
Levy
Kuojen
K
Tsao
Mikael
M
Petrosyan
Timothy D
TD
Kane
Elizabeth M
EM
Pontarelli
Jeffrey S
JS
Upperman
Marcus
M
Malek
R Cartland
RC
Burns
Sarah
S
Hill
Mark L
ML
Wulkan
Shawn D
SD
St Peter
D002648:Child; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D061646:Operative Time; D010179:Pancreas / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D010180:Pancreatectomy / Q000379:methods*; D011183:Postoperative Complications; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014193:Trauma Centers; D016896:Treatment Outcome