چکیده (انگلیسی):

growing movement for non-operative management. in blunt pancreatic trauma. Very few studies
compare operative versus non-operative management in adult patients.
Methods: Retrospective analysis of a prospectively maintained database was performed from 2004 to
2013 in the department of gastrointestinal surgery, NIMS, Hyderabad. Comparative analysis was performed
between patients who failed versus those who were successfully managed with non-operative
management.
Results: 34 patients had grade III/IV trauma out of which 8 were operated early with the remaining 26
initially under a NOM strategy, 10 of them could be successfully managed without any operation. Posttraumatic
pancreatitis, Necrotizing pancreatitis, Ileus, contusion on CT, surrounding organ injuries are
independently associated with failure of NOM on a univariate analysis. On multivariate logistic regression
presence of necrosis& associated organ injury are factors that predict failure of NOM independently.
Development of a pseudocyst is the only significant factor that is associated with a success of NOM.
Conclusions: Non-operative measures should be attempted in a select group of grade III&IV blunt
pancreatic trauma. In hemodynamically stable patients with a controlled leak walled off as a pseudocyst
without associated organ injuries and pancreatic necrosis, NOM has a higher success rate.