Abstract
Pancreatic trauma is a relatively rare abdominal injury, with a mortality rate of approximately 15% when the cause of injury is blunt trauma or a stab wound. The mortality rate tends to be higher when the patient is in a state of shock on arrival at hospital. The mortality rate also rises when associated organ injury is present, or when surgical treatment for pancreatic duct disruption is deferred because of a delayed diagnosis. In the absence of these risk factors for mortality, pancreatic duct repair (PDR) is an adaptable procedure, provided that the injured pancreatic site is localized to a small area within the pancreatic neck or body. PDR consists of creating an end-to-end anastomosis of the pancreatic duct and pancreatic parenchyma. Insertion of a stent through the pancreatic duct is necessary to avoid duct stenosis and to reduce ductal pressure. Postoperative pancreatic complications following PDR include pancreatic fistula (26%), pancreatitis (13%), pancreatic cyst (8.7%), and intra-abdominal abscess (4.3%). The normal intra-operative time for PDR is 200 min in our institution. In comparison with distal pancreatectomy, the rate of postoperative pancreatic complications following PDR is slightly higher, except for intra-abdominal abscesses; the intra-operative time for PDR is also longer. However, PDR is a preferable procedure with regard to preservation of pancreatic and splenic function. In addition, reconstruction is anatomically and physiologically simple.
