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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Surgical management and outcome of civilian gunshot injuries to the pancreas
British Journal of Surgery, Volume 99, No. SUPPL. 1, Year 2012
Notification
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Description
Background: Pancreatic injuries are uncommon but result in substantial morbidity and mortality. This study evaluated the factors associated with morbidity and mortality in civilian patients with pancreatic gunshot wounds. Methods: This was a single-institution, retrospective review of patients with gunshot wounds of the pancreas treated from 1976 to 2009 in Cape Town, South Africa. Univariable and multivariable analyses were performed. Results: A total of 219 patients (205 male, median age 27 years) had pancreatic American Association for the Surgery of Trauma grade I-II (111 patients) and grade III-V (108) gunshot injuries to the pancreatic head (72), neck (8), body (75) and tail (64). The patients underwent 239 laparotomies, including drainage of the pancreas (169), distal pancreatectomy (59) and pancreaticoduodenectomy (11). Some 218 patients had 642 associated intra-abdominal and 91 vascular injuries. Forty-three (19·6 per cent) required an initial damage control procedure. A total of 150 patients (68·5 per cent) had 407 postoperative complications (median 4, range 1-7). The 46 patients (21·0 per cent) who died had a median of 3 (range 1-7) complications. Median (range) intensive care unit and total hospital stay were 5 (1-153) and 11 (1-255) days respectively. Multivariable analyses identified age, high-grade pancreatic injury, associated vascular injuries and need for repeat laparotomy as predictors of morbidity. Age, shock on admission, need for damage control surgery, high-grade pancreatic injuries and associated vascular injuries were significant factors associated with mortality. Conclusion: Morbidity and mortality rates were high after gunshot injuries to the pancreas. Initial shock and severe injury combined with need for damage control surgery were associated with the highest risk of death. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Authors & Co-Authors
Chinnery, Galya E.
South Africa, Cape Town
Faculty of Health Sciences
Krige, Jacobus E.J.
South Africa, Cape Town
Faculty of Health Sciences
Kotze, Urda K.
South Africa, Cape Town
Faculty of Health Sciences
Navsaria, Pradeep Harkison
South Africa, Cape Town
Faculty of Health Sciences
Nicol, Andrew John
South Africa, Cape Town
Faculty of Health Sciences
Statistics
Citations: 48
Authors: 5
Affiliations: 1
Identifiers
Doi:
10.1002/bjs.7761
ISSN:
00071323
e-ISSN:
13652168
Research Areas
Health System And Policy
Violence And Injury
Study Design
Cohort Study
Study Locations
South Africa
Participants Gender
Male