Colomb Med (Cali)
Professor Emeritus Virginia Commonwealth University, Richmond, VA, USA.
Published: December 2020
Pancreatic trauma is a rare but potentially lethal injury because often it is associated with other abdominal organ or vascular injuries. Usually, it has a late clinical presentation which in turn complicates the management and overall prognosis. Due to the overall low prevalence of pancreatic injuries, there has been a significant lack of consensus among trauma surgeons worldwide on how to appropriately and efficiently diagnose and manage them. The accurate diagnosis of these injuries is difficult due to its anatomical location and the fact that signs of pancreatic damage are usually of delayed presentation. The current surgical trend has been moving towards organ preservation in order to avoid complications secondary to exocrine and endocrine function loss and/or potential implicit post-operative complications including leaks and fistulas. The aim of this paper is to propose a management algorithm of patients with pancreatic injuries via an expert consensus. Most pancreatic injuries can be managed with a combination of hemostatic maneuvers, pancreatic packing, parenchymal wound suturing and closed surgical drainage. Distal pancreatectomies with the inevitable loss of significant amounts of healthy pancreatic tissue must be avoided. General principles of damage control surgery must be applied when necessary followed by definitive surgical management when and only when appropriate physiological stabilization has been achieved. It is our experience that viable un-injured pancreatic tissue should be left alone when possible in all types of pancreatic injuries accompanied by adequate closed surgical drainage with the aim of preserving primary organ function and decreasing short and long term morbidity.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7968433 | PMC |
http://dx.doi.org/10.25100/cm.v51i4.4361 | DOI Listing |
Ecotoxicol Environ Saf
January 2025
West China Center of Excellence for Pancreatitis, Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu 610041, China; Regenerative Medicine Research Center, Sichuan University West China Hospital, Chengdu, Sichuan 610041, China. Electronic address:
Dichlorvos (DDVP) is an organophosphorus pesticide commonly utilized in agricultural production. Recent epidemiological studies suggest that exposure to DDVP correlates with an increased incidence of liver disease. However, data regarding the hepatotoxicity of DDVP remain limited.
View Article and Find Full Text PDFImmunol Res
January 2025
Department of Hepatopancreatobiliary Surgery, Qingdao Municipal Hospital, Qingdao, Shandong, China.
Oxidative stress (OS) injury is pivotal in acute pancreatitis (AP) pathogenesis, contributing to inflammatory cascades. Irisin, a ubiquitous cytokine, exhibits antioxidant properties. However, the role of irisin in AP remains inconclusive.
View Article and Find Full Text PDFAnn Surg Oncol
January 2025
Division of Pancreatic Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Introduction: Laparoscopic distal pancreatectomy (LDP) has the advantages of reduced blood loss, shorter hospital stays, and a better postoperative quality of life compared with open distal pancreatectomy (ODP). Meanwhile, spleen-preserving laparoscopic distal pancreatectomy is the preferred technique for low-grade malignant and benign tumors located in pancreatic body and tail, since it preserves the immune function of the spleen. The splenic-vessel-preserving (SVP) Kimura technique and splenic vessel resection Warshaw technique are the two primary procedures.
View Article and Find Full Text PDFJ Mater Chem B
January 2025
College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu 610065, China.
Circulating histones have been identified as essential mediators that lead to hyperinflammation, platelet aggregation, coagulation cascade activation, endothelial cell injury, multiple organ dysfunction, and death in severe patients with sepsis, multiple trauma, COVID-19, acute liver failure, and pancreatitis. Clinical evidence suggests that plasma levels of circulating histones are positively associated with disease severity and survival in patients with such critical diseases. However, safe and efficient therapeutic strategies targeting circulating histones are lacking in current clinical practice.
View Article and Find Full Text PDFInfect Drug Resist
January 2025
Department of Clinical Laboratory Science, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, People's Republic of China.
Objective: This study investigated the distribution and changes in pancreatic infections among patients with acute pancreatitis (AP) from 2019 to 2023, while exploring the impact of multidrug-resistant bacterial infections on the prognosis of patients with poor outcomes.
Methods: This study included patients diagnosed with SAP between 2019 and 2023 and collected the demographic and clinical characteristics of all participants. Based on routine clinical microbiological culture results, the distribution and drug resistance of pathogens associated with pancreatic infections were analyzed.
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