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  1. Article ; Online: Thinking like a freak in acute care surgery.

    Biffl, Walter L

    The journal of trauma and acute care surgery

    2023  Volume 95, Issue 5, Page(s) 615–620

    Language English
    Publishing date 2023-06-12
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2651070-4
    ISSN 2163-0763 ; 2163-0755
    ISSN (online) 2163-0763
    ISSN 2163-0755
    DOI 10.1097/TA.0000000000004076
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 127: Show issues Location:
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  2. Article ; Online: Control of pelvic fracture-related hemorrhage.

    Biffl, Walter L

    Surgery open science

    2022  Volume 8, Page(s) 23–26

    Abstract: This is a paper about pelvic fracture-related bleeding control. ...

    Abstract This is a paper about pelvic fracture-related bleeding control.
    Language English
    Publishing date 2022-01-26
    Publishing country United States
    Document type Journal Article
    ISSN 2589-8450
    ISSN (online) 2589-8450
    DOI 10.1016/j.sopen.2022.01.001
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Diagnosis and management of blunt cardiac injury: What you need to know.

    Biffl, Walter L / Fawley, Jason A / Mohan, Rajeev C

    The journal of trauma and acute care surgery

    2023  Volume 96, Issue 5, Page(s) 685–693

    Abstract: Abstract: Blunt cardiac injury (BCI) encompasses a wide spectrum, from occult and inconsequential contusion to rapidly fatal cardiac rupture. A small percentage of patients present with abnormal electrocardiogram or shock, but most are initially ... ...

    Abstract Abstract: Blunt cardiac injury (BCI) encompasses a wide spectrum, from occult and inconsequential contusion to rapidly fatal cardiac rupture. A small percentage of patients present with abnormal electrocardiogram or shock, but most are initially asymptomatic. The potential for sudden dysrhythmia or cardiac pump failure mandates consideration of the presence of BCI, including appropriate monitoring and management. In this review, we will present what you need to know to diagnose and manage BCI.
    MeSH term(s) Humans ; Wounds, Nonpenetrating/therapy ; Wounds, Nonpenetrating/diagnosis ; Wounds, Nonpenetrating/complications ; Heart Injuries/diagnosis ; Heart Injuries/therapy ; Myocardial Contusions/diagnosis ; Myocardial Contusions/therapy ; Myocardial Contusions/complications ; Electrocardiography
    Language English
    Publishing date 2023-12-04
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2651070-4
    ISSN 2163-0763 ; 2163-0755
    ISSN (online) 2163-0763
    ISSN 2163-0755
    DOI 10.1097/TA.0000000000004216
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 127: Show issues Location:
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  4. Article ; Online: Evidence-based medicine in trauma/acute care surgery- what does that look like?

    Biffl, Walter L

    American journal of surgery

    2018  Volume 217, Issue 6, Page(s) 1000–1005

    MeSH term(s) Emergency Medicine/methods ; Emergency Medicine/standards ; Evidence-Based Medicine/methods ; Evidence-Based Medicine/standards ; Humans ; Traumatology/methods ; Traumatology/standards ; United States
    Language English
    Publishing date 2018-09-25
    Publishing country United States
    Document type Journal Article ; Lecture
    ZDB-ID 2953-1
    ISSN 1879-1883 ; 0002-9610
    ISSN (online) 1879-1883
    ISSN 0002-9610
    DOI 10.1016/j.amjsurg.2018.09.017
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  5. Article ; Online: Should surgeon-performed intraoperative ultrasound be the preferred test for detecting main pancreatic duct injuries in operative trauma cases?

    Ball, Chad G / Biffl, Walter L / Moore, Ernest E / Hagopian, Ellen J

    The journal of trauma and acute care surgery

    2023  Volume 96, Issue 3, Page(s) 461–465

    Abstract: Background: The diagnostic performance of multiple tests for detecting the presence of a main pancreatic duct injury remains poor. Given the central importance of main duct integrity for both subsequent treatment algorithms and patient outcomes, poor ... ...

    Abstract Background: The diagnostic performance of multiple tests for detecting the presence of a main pancreatic duct injury remains poor. Given the central importance of main duct integrity for both subsequent treatment algorithms and patient outcomes, poor test reliability is problematic. The primary aim was to evaluate the comparative test performance of computed tomography (CT), magnetic resonance cholangiopancreatography (MRCP), endoscopic retrograde cholangiopancreatography (ERCP), and intraoperative ultrasound (IOUS) for detecting main pancreatic duct injuries.
    Methods: All severely injured adult patients with pancreatic trauma (2010-2021) were evaluated. Patients who received an IOUS pancreas-focused evaluation, with Grades III, IV, and V injuries (main duct injury) were compared with those with Grade I and Grade II trauma (no main duct injury). Test performances were analyzed.
    Results: Of 248 pancreatic injuries, 74 underwent an IOUS. The additional mix of diagnostic studies (CT, MRCP, ERCP) was variable across grade of injury. Of these 74 IOUS cases for pancreatic injuries, 48 (64.8%) were confirmed as Grades III, IV, or V main duct injuries. The patients were predominantly young (median age = 33, IQR:21-45) blunt injured (70%) males (74%) with severe injury demographics (injury severity score = 28, (IQR:19-36); 30% hemodynamic instability; 91% synchronous intra-abdominal injuries). Thirty-five percent of patients required damage-control surgery. Patient outcomes included a median 13-day hospital length of stay and 1% mortality rate. Test performance was variable across groups (CT = 58% sensitive/77% specific; MRCP = 71% sensitive/100% specific; ERCP = 100% sensitive; IOUS = 98% sensitive/100% specific).
    Conclusion: Intraoperative ultrasound is a highly sensitive and specific test for detecting main pancreatic duct injuries. This technology is simple to learn, readily available, and should be considered in patients who require concurrent non-damage-control abdominal operations.
    Level of evidence: Diagnostic Test/Criteria; Level III.
    MeSH term(s) Male ; Humans ; Adult ; Female ; Pancreatic Ducts/injuries ; Reproducibility of Results ; Pancreas/diagnostic imaging ; Pancreas/surgery ; Pancreas/injuries ; Cholangiopancreatography, Endoscopic Retrograde/methods ; Pancreatic Diseases ; Abdominal Injuries/diagnostic imaging ; Abdominal Injuries/surgery ; Thoracic Injuries ; Surgeons ; Wounds, Nonpenetrating/diagnostic imaging ; Wounds, Nonpenetrating/surgery ; Retrospective Studies
    Language English
    Publishing date 2023-08-21
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2651070-4
    ISSN 2163-0763 ; 2163-0755
    ISSN (online) 2163-0763
    ISSN 2163-0755
    DOI 10.1097/TA.0000000000004107
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 127: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    ab Jg. 2022: Lesesaal (EG)

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  6. Article ; Online: The nuanced nature of grading pancreas injuries: Response to letter to the editor.

    Ball, Chad G / Biffl, Walter L / Moore, Ernest E

    The journal of trauma and acute care surgery

    2022  Volume 93, Issue 2, Page(s) e96

    MeSH term(s) Abdominal Injuries/diagnosis ; Humans ; Pancreas ; Pancreatic Diseases ; Thoracic Injuries
    Language English
    Publishing date 2022-05-18
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 2651070-4
    ISSN 2163-0763 ; 2163-0755
    ISSN (online) 2163-0763
    ISSN 2163-0755
    DOI 10.1097/TA.0000000000003690
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 127: Show issues Location:
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  7. Article ; Online: International Association of Trauma and Surgical Intensive Care Symposium: Penetrating Trauma. Update on Penetrating Trauma.

    Biffl, Walter L

    World journal of surgery

    2015  Volume 39, Issue 6, Page(s) 1341–1342

    Language English
    Publishing date 2015-06
    Publishing country United States
    Document type Introductory Journal Article
    ZDB-ID 224043-9
    ISSN 1432-2323 ; 0364-2313
    ISSN (online) 1432-2323
    ISSN 0364-2313
    DOI 10.1007/s00268-015-3059-8
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  8. Article ; Online: Exploring the role of endovascular interventions in blunt carotid and vertebral artery trauma.

    Biffl, Walter L / Castelo, Matthew / Dandan, Imad S / Lu, Ning / Rivera, Patricia / Bayat, Dunya

    American journal of surgery

    2023  Volume 226, Issue 5, Page(s) 688–691

    Abstract: Background: The role of endovascular interventions (EI) for blunt carotid and vertebral artery injuries (BCI and BVI) is poorly defined. The purpose of this study was to assess the efficacy of EI compared with antithrombotic therapy (AT) to inform ... ...

    Abstract Background: The role of endovascular interventions (EI) for blunt carotid and vertebral artery injuries (BCI and BVI) is poorly defined. The purpose of this study was to assess the efficacy of EI compared with antithrombotic therapy (AT) to inform future prospective study.
    Methods: Retrospective review (2017-2022) of records at a Level I trauma center to determine injury, treatment, and outcome information. Primary outcome was stroke.
    Results: 96 patients suffered 106 injuries (74 BVI, 32 BCI). 12 patients underwent 13 EI- 4 therapeutic, 9 prophylactic. Stroke occurred in 12 patients- 6 who had EI. In grade IV BVI, stroke rates are low with both EI and AT. Thrombectomy after stroke improved neurologic function in 4 (100%) of 4 patients.
    Conclusions: Most strokes occur prior to preventive therapy. Neither AT nor EI is 100% effective in preventing stroke. Thrombectomy may improve neurologic outcomes after stroke. Prospective multicenter study is imperative.
    MeSH term(s) Humans ; Carotid Artery Injuries/surgery ; Craniocerebral Trauma ; Neck Injuries ; Prospective Studies ; Retrospective Studies ; Stroke ; Treatment Outcome ; Vertebral Artery/surgery ; Vertebral Artery/injuries ; Wounds, Nonpenetrating/complications ; Wounds, Nonpenetrating/therapy
    Language English
    Publishing date 2023-07-24
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2953-1
    ISSN 1879-1883 ; 0002-9610
    ISSN (online) 1879-1883
    ISSN 0002-9610
    DOI 10.1016/j.amjsurg.2023.07.030
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Time to update the American Association for the Surgery of Trauma pancreas injury grading lexicon?

    Ball, Chad G / Biffl, Walter L / Moore, Ernest E

    The journal of trauma and acute care surgery

    2021  Volume 92, Issue 3, Page(s) e38–e40

    MeSH term(s) Humans ; Pancreas/injuries ; Pancreas/surgery ; Trauma Severity Indices ; United States
    Language English
    Publishing date 2021-10-27
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2651070-4
    ISSN 2163-0763 ; 2163-0755
    ISSN (online) 2163-0763
    ISSN 2163-0755
    DOI 10.1097/TA.0000000000003452
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 127: Show issues Location:
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  10. Article ; Online: Current use and utility of magnetic resonance cholangiopancreatography, endoscopic retrograde cholangiopancreatography, and pancreatic duct stents: A secondary analysis from the Western Trauma Association multicenter trials group on pancreatic injuries.

    Biffl, Walter L / Ball, Chad G / Moore, Ernest E / West, Michaela / Russo, Rachel M / Balogh, Zsolt J / Kornblith, Lucy / Castelo, Matthew

    The journal of trauma and acute care surgery

    2023  Volume 95, Issue 5, Page(s) 719–725

    Abstract: Introduction: The single most important predictor of pancreas-specific complications (PSCs) after pancreatic trauma is injury to the main pancreatic duct (MPD). Pancreatography has been recommended to evaluate the integrity of the MPD. In addition, ... ...

    Abstract Introduction: The single most important predictor of pancreas-specific complications (PSCs) after pancreatic trauma is injury to the main pancreatic duct (MPD). Pancreatography has been recommended to evaluate the integrity of the MPD. In addition, pancreatic duct stents have been proposed to prevent or treat PSC. The primary purpose of this study was to determine the accuracy of magnetic resonance cholangiopancreatography (MRCP) in diagnosing MPD injury. We further sought to determine whether stents were effective in preventing PSC or facilitated the resolution of pancreatic leaks or fistulae.
    Methods: A secondary analysis of a multicenter retrospective review of pancreatic injuries in patients 15 years and older from 2010 to 2018, focusing on patients who underwent MRCP or endoscopic retrograde cholangiopancreatography (ERCP), was performed. Final pancreatic injury grade was determined based on all available assessments, ultimately adjudicated by the site principal investigator. Data were analyzed using various statistical tests where appropriate.
    Results: Thirty-three centers reported on 1,243 patients. A total of 216 underwent pancreatography-137 had MRCP and 115 ERCP, with 36 having both. The sensitivity of MRCP for MPD injury was 37%, the specificity was 94%, the positive predictive value was 77%, and the negative predictive value was 73%. When compared with ERCP, MRCP findings were discordant in 64% of cases. Pancreatic stents were placed in 77 patients; 48 (62%) were to treat PSC, with no clear benefit. Twenty-nine had prophylactic stents placed. There did not appear to be benefit in reduced PSC compared with the entire study group or among patients with high-grade pancreatic injuries.
    Conclusion: The accuracy of MRCP to evaluate the integrity of the MPD does not appear to be superior to computed tomography scan. Consequently, the results of MRCP should be interpreted with caution. The current data do not support prophylactic use of pancreatic stents; they should be studied in a prospective trial.
    Level of evidence: Therapeutic/Care Management; Level III.
    MeSH term(s) Humans ; Abdominal Injuries/pathology ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangiopancreatography, Magnetic Resonance ; Magnetic Resonance Spectroscopy ; Pancreas/diagnostic imaging ; Pancreas/surgery ; Pancreas/pathology ; Pancreatic Diseases/diagnosis ; Pancreatic Ducts/diagnostic imaging ; Pancreatic Ducts/surgery ; Pancreatic Ducts/injuries ; Stents ; Thoracic Injuries ; Retrospective Studies
    Language English
    Publishing date 2023-05-01
    Publishing country United States
    Document type Multicenter Study ; Journal Article
    ZDB-ID 2651070-4
    ISSN 2163-0763 ; 2163-0755
    ISSN (online) 2163-0763
    ISSN 2163-0755
    DOI 10.1097/TA.0000000000003990
    Database MEDical Literature Analysis and Retrieval System OnLINE

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