Diagnosis and treatment of traumatic pancreatic injury: A report of 60 cases

Objective To summarize the experience in diagnosis and treatment of traumatic pancreatic injury. Methods Clinical data about 60 patients with pancreatic injury admitted to our hospital from August 1993 to September 2012 were retrospectively analyzed. Results Of the 60 traumatic pancreatic injury patients, 25 were classified as gradeⅠinjury, 19 as gradeⅡinjury,6 as grade Ⅲ injury,6 as grade Ⅳ injury and 4 as gradeⅤ injury according to the AAST classification. Of these patients, 17 underwent conservative treatment and 43 underwent surgical treatment. Of the 43 patients who underwent surgical treatment, 29 underwent pancreatic injury repair and drainage, 5 pancreaticojejunostomy, 2 pancreatoduodenectomy, 1 distal pancrea resection, 4 operative exploration, 2 primary debridement and secondary pancreaticojejunostomy. Of the 60 patients, 54 were cured, 4 died and 2 gave up treatment, with no complication occurred in 29, but pancreatic fistula in 15, abdominal infection in 9, pancreatic pseudocyst in 8, pancreatic duct stenosis in 1, multiple organ failure in 2. Conclusion Surgical procedure for the treatment of pancreatic injury should be decided according to its specific condition. Damage-control procedure should be performed for severe pancreatic injury. Sufficient postoperative drainage is the key to the prevention of complications after operation.