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

TY - JOUR

T1 - Non-operative versus operative treatment for blunt pancreatic trauma in children

AU - Haugaard, Michael V

AU - Wettergren, André

AU - Hillingsø, Jens Georg

AU - Gluud, Christian

AU - Penninga, Luit

PY - 2014/2/12

Y1 - 2014/2/12

N2 - BACKGROUND: Pancreatic trauma in children is a serious condition with high morbidity. Blunt traumatic pancreatic lesions in children can be treated non-operatively or operatively. For less severe, grade I and II, blunt pancreatic trauma a non-operative or conservative approach is usually employed. Currently, the optimal treatment, of whether to perform operative or non-operative treatment of severe, grade III to V, blunt pancreatic injury in children is unclear.OBJECTIVES: To assess the benefits and harms of operative versus non-operative treatment of blunt pancreatic trauma in children.SEARCH METHODS: We searched the Cochrane Injuries Group's Specialised Register, Cochrane Central Register of Controlled Trials (Issue 5, 2013), MEDLINE (OvidSP), EMBASE (OvidSP), ISI Web of Science (SCI-EXPANDED and CPCI-S) and ZETOC. In addition, we searched bibliographies of relevant articles, conference proceeding abstracts and clinical trials registries. We conducted the search on the 21 June 2013.SELECTION CRITERIA: We planned to select all randomised clinical trials investigating non-operative versus operative treatment of blunt pancreatic trauma in children, irrespective of blinding, publication status or language of publication.DATA COLLECTION AND ANALYSIS: We used relevant search strategies to obtain the titles and abstracts of studies that were relevant for the review. Two review authors independently assessed trial eligibility.MAIN RESULTS: The search found 83 relevant references. We excluded all of the references and found no randomised clinical trials investigating treatment of blunt pancreatic trauma in children.AUTHORS' CONCLUSIONS: This review shows that strategies regarding non-operative versus operative treatment of severe blunt pancreatic trauma in children are not based on randomised clinical trials. We recommend that multi-centre trials evaluating non-operative versus operative treatment of paediatric pancreatic trauma are conducted to establish firm evidence in this field of medicine.

AB - BACKGROUND: Pancreatic trauma in children is a serious condition with high morbidity. Blunt traumatic pancreatic lesions in children can be treated non-operatively or operatively. For less severe, grade I and II, blunt pancreatic trauma a non-operative or conservative approach is usually employed. Currently, the optimal treatment, of whether to perform operative or non-operative treatment of severe, grade III to V, blunt pancreatic injury in children is unclear.OBJECTIVES: To assess the benefits and harms of operative versus non-operative treatment of blunt pancreatic trauma in children.SEARCH METHODS: We searched the Cochrane Injuries Group's Specialised Register, Cochrane Central Register of Controlled Trials (Issue 5, 2013), MEDLINE (OvidSP), EMBASE (OvidSP), ISI Web of Science (SCI-EXPANDED and CPCI-S) and ZETOC. In addition, we searched bibliographies of relevant articles, conference proceeding abstracts and clinical trials registries. We conducted the search on the 21 June 2013.SELECTION CRITERIA: We planned to select all randomised clinical trials investigating non-operative versus operative treatment of blunt pancreatic trauma in children, irrespective of blinding, publication status or language of publication.DATA COLLECTION AND ANALYSIS: We used relevant search strategies to obtain the titles and abstracts of studies that were relevant for the review. Two review authors independently assessed trial eligibility.MAIN RESULTS: The search found 83 relevant references. We excluded all of the references and found no randomised clinical trials investigating treatment of blunt pancreatic trauma in children.AUTHORS' CONCLUSIONS: This review shows that strategies regarding non-operative versus operative treatment of severe blunt pancreatic trauma in children are not based on randomised clinical trials. We recommend that multi-centre trials evaluating non-operative versus operative treatment of paediatric pancreatic trauma are conducted to establish firm evidence in this field of medicine.

KW - Child

KW - Humans

KW - Pancreas

KW - Wounds, Nonpenetrating

U2 - 10.1002/14651858.cd009746.pub2

DO - 10.1002/14651858.cd009746.pub2

M3 - Journal article

C2 - 24523209

SN - 1361-6137

VL - 2

SP - CD009746

JO - Cochrane Database of Systematic Reviews

JF - Cochrane Database of Systematic Reviews

ER -