Diagnosis and Treatment of Pancreatic Trauma

Abstract

We reviewed 16 cases with traumatic pancreatic injuries over a 5-year period. The classification system used was the 2008 version of the Japanese Association for the Surgery of Trauma. Under this system, grade IIIb is the most severe type, with pancreatic duct injury. Of our 16 cases 7 were Grade IIIb (head 4, body 2, tail 1). Four cases (IIIb head) were treated with PD and PPPD. Three cases required an emergency room laparotomy (ERL), 2 cases required damage control surgery (DCS) and 1 case required a resuscitation thoracotomy/emergency room thoracotomy (ERT) with a thoracic aorta clamp. Death occurred in 1 case (Grade IIIb Ph). In cases of severe shock due to intra-abdominal hemorrhage, hemostasis via an emergency laparotomy is important. The second priority is the intra-operative diagnosis of the main pancreatic duct. Furthermore, it is necessary to perform DCS.