PHÂN LOẠI CHẤN THƯƠNG TUỴ THEO AAST 2018 VÀ KẾT QUẢ ĐIỀU TRỊ BỆNH NHÂN CHẤN THƯƠNG TỤY TẠI BỆNH VIỆN HỮU NGHỊ VIỆT ĐỨC GIAI ĐOẠN 2017 - 2022

Abstract

Objective: Pancreatic trauma (PT) is a rare injury, accounting for approximately 0.2% of all trauma cases and 3% of abdominal trauma, primarily caused by traffic accidents. This study aims to evaluate PT treatment outcomes based on the American Association for the Surgery of Trauma (AAST) classification (2018). Subjects and Methods: A retrospective descriptive study was conducted on 73 PT patients treated at Viet Duc University Hospital from 2017 to 2022. Results: The mean age was 34.7 ± 15 years, with a male-to-female ratio of 5.6:1. According to the AAST 2018 classification, PT grades I-II were mainly managed conservatively (77.5%), while grades III-V tended to require surgical intervention (72.7%). The rate of associated injuries was high (79.5%), particularly liver, spleen, and kidney injuries (57.5%). Non-surgical treatment (54.8%) primarily involved pancreatic secretion reduction (67.5%), whereas surgical treatment (45.2%) most commonly included distal pancreatectomy with splenectomy (36.4%). Postoperative complications occurred in 45.9%, including pancreatic fistula (16.2%) and intra-abdominal fluid collection (18.9%). The average hospital stay was 16.9 ± 13 days. The mortality rate was 2.74%, mainly due to polytrauma and postoperative complications. Conclusion: Conservative management is appropriate for mild PT cases, whereas surgery is necessary for severe injuries. Pancreatic fistula and intra-abdominal fluid collection are the most common postoperative complications. Optimizing treatment strategies can improve prognosis and reduce complications.