Surgical treatment of pancreatic trauma

Abstract

Pancreatic injuries are rare and the pre-and intraoperative diagnoses rely on high index of suspicion, appropriate radiological investigations, and meticulous exposure during explorative laparotomy. Isolated pancreatic injuries can remain silent at the early stage and manifest later as pancreatic pseudocysts, fistulas, or abscesses. Excluding patients with devastating injuries to the pancreaticoduodenal complex and adjacent vascular injuries, the majority of pancreatic injuries can be managed successfully with adequate exposure during explorative laparotomy and simple surgical procedures. More complex repair techniques, such as distal pancreaticojejunostomy or even pancreaticoduodenectomy, are seldom required. Mortality specifically related to the pancreatic injury itself is relatively low, but postoperative complications are frequent and often associated with delayed diagnosis and treatment.