Journal of Trauma and Injury

The Korean Society of Traumatology (대한외상학회)
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Management of Traumatic Pancreatic Injuries: Evaluation of 7 Years of Experience at a Single Regional Trauma Center

  • Lee, Min A (Department of Trauma Surgery, Gachon University Gil Medical Center) ;
  • Lee, Seung Hwan (Department of Trauma Surgery, Gachon University Gil Medical Center) ;
  • Choi, Kang Kook (Department of Trauma Surgery, Gachon University Gil Medical Center) ;
  • Park, Youngeun (Department of Trauma Surgery, Gachon University Gil Medical Center) ;
  • Lee, Gil Jae (Department of Trauma Surgery, Gachon University Gil Medical Center) ;
  • Yu, Byungchul (Department of Trauma Surgery, Gachon University Gil Medical Center)
  • Received : 2021.08.28
  • Accepted : 2021.09.23
  • Published : 2021.09.30
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Abstract

Purpose: Traumatic pancreatic injuries are rare, but their diagnosis and management are challenging. The aim of this study was to evaluate and report our experiences with the management of pancreatic injuries. Methods: We identified all adult patients (age >15) with pancreatic injuries from our trauma registry over a 7-year period. Data related to patients' demographics, diagnoses, operative information, complications, and hospital course were abstracted from the registry and medical records. Results: A total of 45 patients were evaluated. Most patients had blunt trauma (89%) and 21 patients (47%) had pancreatic injuries of grade 3 or higher. Twenty-eight patients (62%) underwent laparotomy and 17 (38%) received nonoperative management (NOM). The overall in-hospital mortality rate was 24% (n=11), and only one patient died after NOM (due to a severe traumatic brain injury). Twenty-two patients (79%) underwent emergency laparotomy and six (21%) underwent delayed laparotomy. A drainage procedure was performed in 12 patients (43%), and pancreatectomy was performed in 16 patients (57%) (distal pancreatectomy [DP], n=8; DP with spleen preservation, n=5; pancreaticoduodenectomy, n=2; total pancreatectomy, n=1). Fourteen (31%) pancreas-specific complications occurred, and all complications were successfully managed without surgery. Solid organ injuries (n=14) were the most common type of associated abdominal injury (Abbreviated Injury Scale ≥3). Conclusions: For traumatic pancreatic injuries, an appropriate treatment method should be considered after evaluation of the accompanying injury and the patient's hemodynamic status. NOM can be performed without mortality in appropriately selected cases.

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References

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