Management of pancreatic trauma: A pancreatic surgeon's point of view

Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Calogero IaconoAlfredo Guglielmi

Abstract

Pancreatic trauma occurs in 0.2% of patients with blunt trauma and 1-12% of patients with penetrating trauma. Traumatic pancreatic injuries are characterised by high morbidity and mortality, which further increase with delayed diagnoses. The diagnosis of pancreatic trauma is challenging. Signs and symptoms can be non-specific or even absent. A critical review of studies reporting the management and outcomes of pancreatic trauma was performed. The management of pancreatic trauma depends on the haemodynamic stability of the patient, the degree and location of parenchymal injury, the integrity of the main pancreatic duct, and the associated injuries to other organs. Nevertheless, the involvement of the main pancreatic duct is the most important predictive factor of the outcome. The majority of pancreatic traumas are managed by medical treatment (parenteral nutrition, antibiotic therapy and somatostatin analogues), haemostasis, debridement of devitalised tissue and closed external drainage. If a proximal duct injury is diagnosed, endoscopic transpapillary stent insertion can be a viable option, while surgical resection by pancreaticoduodenectomy is restricted to an extremely small number of selected cases. Injuries of the distal pa...Continue Reading

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Oct 17, 2020·The Journal of International Medical Research·Yuichi AokiNaohiro Sata

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