title: Non-operative versus operative treatment for blunt pancreatic trauma in children.
abstract: BACKGROUND
  Pancreatic trauma in children is a serious condition with high morbidity. Blunt traumatic pancreatic lesions in children can be treated non-operatively or operatively. For less severe, grade I and II, blunt pancreatic trauma a non-operative or conservative approach is usually employed. Currently, the optimal treatment, of whether to perform operative or non-operative treatment of severe, grade III to V, blunt pancreatic injury in children is unclear.
  
  
  OBJECTIVE
  To assess the benefits and harms of operative versus non-operative treatment of blunt pancreatic trauma in children.
  
  
  METHODS
  We searched the Cochrane Injuries Group's Specialised Register, Cochrane Central Register of Controlled Trials (Issue 5, 2013), MEDLINE (OvidSP), EMBASE (OvidSP), ISI Web of Science (SCI-EXPANDED and CPCI-S) and ZETOC. In addition, we searched bibliographies of relevant articles, conference proceeding abstracts and clinical trials registries. We conducted the search on the 21 June 2013.
  
  
  METHODS
  We planned to select all randomised clinical trials investigating non-operative versus operative treatment of blunt pancreatic trauma in children, irrespective of blinding, publication status or language of publication.
  
  
  METHODS
  We used relevant search strategies to obtain the titles and abstracts of studies that were relevant for the review. Two review authors independently assessed trial eligibility.
  
  
  RESULTS
  The search found 83 relevant references. We excluded all of the references and found no randomised clinical trials investigating treatment of blunt pancreatic trauma in children.
  
  
  CONCLUSIONS
  This review shows that strategies regarding non-operative versus operative treatment of severe blunt pancreatic trauma in children are not based on randomised clinical trials. We recommend that multi-centre trials evaluating non-operative versus operative treatment of paediatric pancreatic trauma are conducted to establish firm evidence in this field of medicine.
authors: Department of Surgery and Transplantation C2122, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, Copenhagen, Denmark, DK-2100 Ø
authors: Michael V
authors: MV
authors: Haugaard
authors: André
authors: A
authors: Wettergren
authors: Jens Georg
authors: JG
authors: Hillingsø
authors: Christian
authors: C
authors: Gluud
authors: Luit
authors: L
authors: Penninga
mesh_terms: D002648:Child; D006801:Humans; D010179:Pancreas / Q000293:injuries*; D014949:Wounds, Nonpenetrating / Q000601:surgery / Q000628:therapy*