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Non-operative versus operative treatment for blunt pancreatic trauma in children

Michael V Haugaard1, André Wettergren, Jens Georg Hillingsø

  • 1Department of Surgery and Transplantation C2122, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, Copenhagen, Denmark, DK-2100 Ø

The Cochrane Database of Systematic Reviews
|February 14, 2014
PubMed

Insights

Evidence for treating severe blunt pancreatic trauma in children is lacking. This review found no randomized clinical trials, highlighting the need for multi-center studies on operative versus non-operative management.

Area of Science:

  • Pediatric Surgery
  • Trauma Management
  • Gastrointestinal Surgery

Background:

  • Pancreatic trauma in children is a severe condition associated with significant morbidity.
  • Treatment options for blunt pancreatic lesions include non-operative and operative approaches.
  • The optimal management strategy for severe (grade III-V) blunt pancreatic injuries in children remains unclear.

Purpose of the Study:

  • To evaluate the benefits and harms of operative versus non-operative treatment for blunt pancreatic trauma in pediatric patients.

Main Methods:

  • A comprehensive literature search was conducted across multiple databases including Cochrane, MEDLINE, EMBASE, and Web of Science up to June 21, 2013.
  • The review aimed to include all randomized clinical trials comparing operative and non-operative management of blunt pancreatic trauma in children.
  • Study eligibility was independently assessed by two review authors.

Main Results:

  • The search identified 83 relevant references.
  • However, no randomized clinical trials investigating the treatment of blunt pancreatic trauma in children were found and all references were excluded.

Conclusions:

  • Current treatment strategies for severe blunt pancreatic trauma in children are not supported by evidence from randomized clinical trials.
  • There is a critical need for multi-center trials to establish robust evidence for operative versus non-operative management in pediatric pancreatic trauma.
Abstract

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