Observational Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Mar 27, 2017; 9(3): 82-91
Published online Mar 27, 2017. doi: 10.4240/wjgs.v9.i3.82
Resection of complex pancreatic injuries: Benchmarking postoperative complications using the Accordion classification
Jake E Krige, Eduard Jonas, Sandie R Thomson, Urda K Kotze, Mashiko Setshedi, Pradeep H Navsaria, Andrew J Nicol
Jake E Krige, Eduard Jonas, Urda K Kotze, Surgical Gastroenterology Unit, Department of Surgery, University of Cape Town Health Sciences Faculty, Observatory, Cape Town 7925, South Africa
Jake E Krige, Eduard Jonas, Sandie R Thomson, Urda K Kotze, Mashiko Setshedi, Pradeep H Navsaria, Andrew J Nicol, Groote Schuur Hospital, Observatory, Cape Town 7925, South Africa
Sandie R Thomson, Mashiko Setshedi, Department of Medicine, University of Cape Town Health Sciences Faculty, Cape Town 7925, South Africa
Pradeep H Navsaria, Andrew J Nicol, Department of Surgery, Trauma Centre, University of Cape Town Health Sciences Faculty, Observatory, Cape Town 7925, South Africa
Author contributions: Krige JE designed and conducted the study; Krige JE, Jonas E and Kotze UK collected and analysed and interpreted the data; Setshedi M performed the statistical analysis; Krige JE, Jonas E, Thomson SR drafted the manuscript; Navsaria PH and Nicol AJ conducted critical revisions; all authors read and approved the final version of the manuscript.
Institutional review board statement: This study was approved by the Human Research Ethics Committee, University of Cape Town Health Sciences Faculty.
Informed consent statement: Patient informed consent for data analysis was not required, as anonymized clinical data were used for this study.
Conflict-of-interest statement: The authors declare no conflict of interests.
Data sharing statement: No data sharing.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Jake E Krige, Professor, Surgical Gastroenterology Unit, Department of Surgery, University of Cape Town Health Sciences Faculty, Anzio Road, Observatory, Cape Town 7925, South Africa. jej.krige@uct.ac.za
Telephone: +27-21-4043072 Fax: +27-21-4480981
Received: August 25, 2016
Peer-review started: August 27, 2016
First decision: September 27, 2016
Revised: December 28, 2016
Accepted: January 16, 2017
Article in press: January 18, 2017
Published online: March 27, 2017
Processing time: 209 Days and 15.9 Hours
Core Tip

Core tip: Pancreatic injuries result in considerable morbidity and mortality rates if the injury is inadequately treated. This analysis benchmarked the severity of complications after pancreatic resection for trauma using the Accordion Severity Grading System. By applying univariate logistic regression analysis, the mechanism of injury, a revised trauma score < 7.8, shock on admission to hospital, the need for an initial damage control laparotomy, an increasing pancreatic injury grade and the type of pancreatic resection were found to be significant variables for complications. However, multivariate logistic regression analysis showed that only age and the type of pancreatic resection were significant. Post-operative morbidity after pancreatic resection for trauma in this study was substantial and an increasing complication severity grade, as measured by the Accordion severity scale, required escalation of intervention and prolonged hospitalisation.