Duodeno-pancreatic and extrahepatic biliary tree trauma: WSES-AAST guidelines

Federico Coccolini, Leslie Kobayashi, Yoram Kluger, Ernest E. Moore, Luca Ansaloni, Walt Biffl, Ari Leppaniemi, Goran Augustin, Viktor Reva, Imitiaz Wani, Andrew Kirkpatrick, Fikri Abu-Zidan, Enrico Cicuttin, Gustavo Pereira Fraga, Carlos Ordonez, Emmanuil Pikoulis, Maria Grazia Sibilla, Ron Maier, Yosuke Matsumura, Peter T. MasiakosVladimir Khokha, Alain Chichom Mefire, Rao Ivatury, Francesco Favi, Vassil Manchev, Massimo Sartelli, Fernando Machado, Junichi Matsumoto, Massimo Chiarugi, Catherine Arvieux, Fausto Catena, Raul Coimbra, Offir Ben-Ishay, Matti Tolonen, Riccardo Bertelli, Tal Horer, Paula Ferrada, Isidoro Di Carlo, Bruno M. Pereira, Dario Parini, Giulia Montori, Belinda De Simone, Osvaldo Chiara, Andreas Hecker, Nicola Deangelis, Carlos Augusto Gomes, Joseph Galante, Miklosh Bala, Konstantinos S. Mylonas, Anastasia Pikoulis, Paola Perfetti, Mircea Chirica, Joaquin Bado, Kenji Inaba, Neil Parry, Oreste Romeo, Martijn Stommel, Mohan Rajashekar, Edward Tan, Francesco Salvetti, Boris Sakakushev

Research output: Contribution to journalReview articlepeer-review

3 Scopus citations

Abstract

Duodeno-pancreatic and extrahepatic biliary tree injuries are rare in both adult and pediatric trauma patients, and due to their anatomical location, associated injuries are very common. Mortality is primarily related to associated injuries, but morbidity remains high even in isolated injuries. Optimal management of duodeno-bilio-pancreatic injuries is dictated primarily by hemodynamic stability, clinical presentation, and grade of injury. Endoscopic and percutaneous interventions have increased the ability to non-operatively manage these injuries. Late diagnosis and treatment are both associated to increased morbidity and mortality. Sequelae of late presentations of pancreatic injury and complications of severe pancreatic trauma are also increasingly addressed endoscopically and with interventional radiology procedures. However, for moderate and severe extrahepatic biliary and severe duodeno-pancreatic injuries, immediate operative intervention is preferred as associated injuries are frequent and commonly present with hemodynamic instability or peritonitis. The aim of this paper is to present the World Society of Emergency Surgery (WSES) and American Association for the Surgery of Trauma (AAST) duodenal, pancreatic, and extrahepatic biliary tree trauma management guidelines.

Original languageEnglish (US)
Article number56
JournalWorld Journal of Emergency Surgery
Volume14
Issue number1
DOIs
StatePublished - Dec 11 2019

Keywords

  • Adult
  • Ampulla
  • Bile duct
  • Biliary tree
  • Classification
  • Conservative
  • Duodenum
  • Endoscopic retrograde cholangiopancreatography (ERCP)
  • Endoscopy
  • Guidelines
  • Injury
  • Non-operative
  • Operative
  • Pancreas
  • Pediatric
  • Surgery
  • Trauma

ASJC Scopus subject areas

  • Surgery
  • Emergency Medicine

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