Damage Control for Duodenal and Combined Duodenal-Pancreatic Injuries

NCT00937118 | Completed Results

• 1 other identifier: IRB # 5128
• Study Type: observational
• Target: 43
• Locations: 1 country
• Sites: 1

Brief Summary

The management of significant duodenal injuries and combined duodenal-pancreatic injuries continues to be challenging and controversial, and several techniques have been advocated over the years. One technique surgeons employ is the damage control/planned reoperation strategy. At the trauma center, the advent of damage control and other planned re-operation strategies has resulted in an evolution in the investigators management of duodenal lacerations and combined duodenal-pancreatic injuries. In this retrospective review, the investigators intend to quantify the investigators change in practice and to report its outcome compared to previous practice. Using the OHSU Trauma Laparotomy Outcomes Database, the investigators will identify all patients receiving trauma laparotomy for a duodenal or duodenal/pancreatic injury for a period of 20 years, from 1989-2009. A number of data points will be retrieved from patients' medical records, including but not limited to grade of duodenal injury, mechanism of injury, Injury Severity Score, and others.

Conditions

Injury of Duodenum; Pancreatic Injury

Keywords

laparotomy; duodenal injury; pancreatic injury; trauma

Outcome Measures

Primary Outcomes (1)

• Duodenal-related Complications

  Duodenal-related complications including leak, obstruction, and abscess

  20 years

Study Arms (1)

Injury Management

Patients with full thickness duodenal laceration undergoing laparotomy and surviving more then 72 hours at our level 1 trauma center in the years 1989-2009. Patients requiring pancreaticoduodenectomy were excluded.

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Trauma patients who received a trauma laparotomy for a duodenal or combined duodenal/pancreatic injury

You may qualify if:

• Trauma patients who received a trauma laparotomy for a duodenal or combined duodenal/pancreatic injury

You may not qualify if:

• None

Sponsors & Collaborators

• Oregon Health and Science University: lead

Study Sites (1)

Oregon Health & Science University

Portland, Oregon, 97239, United States

Location

Related Publications (10)

• Stone HH, Fabian TC. Management of duodenal wounds. J Trauma. 1979 May;19(5):334-9. doi: 10.1097/00005373-197905000-00006.

  PMID: 448769 BACKGROUND

• Snyder WH 3rd, Weigelt JA, Watkins WL, Bietz DS. The surgical management of duodenal trauma. Precepts based on a review of 247 cases. Arch Surg. 1980 Apr;115(4):422-9. doi: 10.1001/archsurg.1980.01380040050009.

  PMID: 7362449 BACKGROUND

• Kashuk JL, Moore EE, Cogbill TH. Management of the intermediate severity duodenal injury. Surgery. 1982 Oct;92(4):758-64.

  PMID: 7123496 BACKGROUND

• Rickard MJ, Brohi K, Bautz PC. Pancreatic and duodenal injuries: keep it simple. ANZ J Surg. 2005 Jul;75(7):581-6. doi: 10.1111/j.1445-2197.2005.03351.x.

  PMID: 15972052 BACKGROUND

• Talving P, Nicol AJ, Navsaria PH. Civilian duodenal gunshot wounds: surgical management made simpler. World J Surg. 2006 Apr;30(4):488-94. doi: 10.1007/s00268-005-0245-0.

  PMID: 16547621 BACKGROUND

• Seamon MJ, Pieri PG, Fisher CA, Gaughan J, Santora TA, Pathak AS, Bradley KM, Goldberg AJ. A ten-year retrospective review: does pyloric exclusion improve clinical outcome after penetrating duodenal and combined pancreaticoduodenal injuries? J Trauma. 2007 Apr;62(4):829-33. doi: 10.1097/TA.0b013e318033a790.

  PMID: 17426536 BACKGROUND

• Rotondo MF, Schwab CW, McGonigal MD, Phillips GR 3rd, Fruchterman TM, Kauder DR, Latenser BA, Angood PA. 'Damage control': an approach for improved survival in exsanguinating penetrating abdominal injury. J Trauma. 1993 Sep;35(3):375-82; discussion 382-3.

  PMID: 8371295 BACKGROUND

• Rotondo MF, Zonies DH. The damage control sequence and underlying logic. Surg Clin North Am. 1997 Aug;77(4):761-77. doi: 10.1016/s0039-6109(05)70582-x.

  PMID: 9291979 BACKGROUND

• Moore EE, Burch JM, Franciose RJ, Offner PJ, Biffl WL. Staged physiologic restoration and damage control surgery. World J Surg. 1998 Dec;22(12):1184-90; discussion 1190-1. doi: 10.1007/s002689900542.

  PMID: 9841741 BACKGROUND

• Mayberry J, Fabricant L, Anton A, Ham B, Schreiber M, Mullins R. Management of full-thickness duodenal laceration in the damage control era: evolution to primary repair without diversion or decompression. Am Surg. 2011 Jun;77(6):681-5.

  PMID: 21679632 RESULT

MeSH Terms

Conditions

Wounds and Injuries

Results Point of Contact

• Title: John Mayberry, MD
• Organization: Oregon Health & Science University

mayberrj@ohsu.edu

503-494-5300

Study Officials

• John C Mayberry, MD

  Oregon Health and Science University

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor of Surgery

Study Record Dates

• First Submitted: July 9, 2009
• First Posted: July 10, 2009
• Study Start: July 1, 2009
• Primary Completion: November 1, 2010
• Study Completion: November 1, 2010
• Last Updated: August 12, 2013
• Results First Posted: August 12, 2013

Record last verified: 2013-05

Locations

US (1)