Systematic review and meta-analysis of the effectiveness and safety of conservative versus surgical management in pediatric pancreatic trauma

Non-operative management is a viable and safe primary strategy in selected pediatric patients with pancreatic trauma and does not appear to increase mortality. The therapeutic decision hinges on a crucial trade-off: NOM increases the risk of pseudocyst formation, while OM increases the risk of iatrogenic fistula. Despite the very low certainty of the available evidence-an inherent limitation of trauma research-these findings provide a critical framework for facilitating shared decision-making. Prospective, multi-center registry studies are urgently needed to establish more definitive guidelines.