Pancreas preserving management of blunt pancreatic trauma: an analysis of 20 cases

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Author:
LIN Xian-chao(Department of General Surgery,Affiliated Union Hospital,Fujian Medical University,Fuzhou 350001,China)
HUANG He-guang(Department of General Surgery,Affiliated Union Hospital,Fujian Medical University,Fuzhou 350001,China)
CHEN Yan-chang(Department of General Surgery,Affiliated Union Hospital,Fujian Medical University,Fuzhou 350001,China)
LU Feng-chun(Department of General Surgery,Affiliated Union Hospital,Fujian Medical University,Fuzhou 350001,China)
LIN Rong-gui(Department of General Surgery,Affiliated Union Hospital,Fujian Medical University,Fuzhou 350001,China)
Journal Title:
CHINESE JOURNAL OF PANCREATOLOGY
Issue:
Volume 10, Issue 05, 2010
DOI:
10.3760/cma.j.issn.1674-1935.2010.05.004
Key Word:
Pancreas;Wounds and injuries;Closed;Individual treatment

Abstract: Objective To improve the management of blunt pancreatic trauma, and to explore the strategy of preserving the pancreatic endocrine and exocrine function to the full extent. Methods 20 cases of blunt pancreatic trauma were reviewed and analyzed retrospectively. The methods of operative treatment were analysed. Results All patients were cured. Depending on the general condition, abnomial signs and main pancreatic duct(MPD) injuries at the time of admission, patients received immediate operation or nonoperative treatment. Because of severe peritonitis and demonstrated MPD injury, 10 patients underwent immediate operations, including simple drainage in 6 cases, distal pancreatectomy in 1 patient, external drainage of the injured pancreatic duct for the second operation in 3 cases. Without the demonstrated MPD injury or clinical deterioration, 10 patients received nonoperative treatment under strict observation initially. 3 patients completed the nonoperative course and 7 patients underwent delayed operations, including Roux-en-Y pancreatic cyst-jejunostomy in 3 cases, external drainage of pseudocyst in e cases, pancreaticoduodenectomy in 1 patient because of the expanded hematoma in pancreatic head. Conclusions Blunt pancreatic trauma could receive individual pancreas-preserving treatment, which could improve the operational safety, avoid the resection of pancreas and preserve the pancreatic endocrine and exocrine function to the full extent.

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