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Distal pancreatectomy for trauma: a multicenter experience.
T H Cogbill1, E E Moore, J A Morris
1Department of Surgery of Gundersen/Lutheran Medical Center, La Crosse, Wisconsin.
The Journal of Trauma
|December 11, 1991
Summary
Distal pancreatic resection effectively manages severe pancreatic injuries from trauma. While complications like abscesses and fistulas occur, long-term exocrine insufficiency is rare following these procedures.
Area of Science:
- Trauma Surgery
- Surgical Gastroenterology
- Surgical Oncology
Background:
- Pancreatic injuries pose significant management challenges.
- Distal pancreatic resection is a critical intervention for severe pancreatic trauma.
- Understanding outcomes and complications is vital for optimizing patient care.
Purpose of the Study:
- To evaluate the outcomes of distal pancreatic resection in patients with pancreatic injuries.
- To analyze complication rates and mortality associated with this surgical approach.
- To assess the long-term functional consequences of pancreatic resection.
Main Methods:
- A retrospective review of 74 patients undergoing distal pancreatic resection for pancreatic injuries over 5 years.
- Data collected included injury mechanism, injury severity, extent of resection, closure methods, and spleen management.
- Outcomes assessed included mortality, pancreas-related complications, and functional insufficiency.
Main Results:
- Blunt trauma was the most common injury mechanism (46%).
- Pancreas-related complications occurred in 45% of survivors, with intra-abdominal abscesses being most frequent (24 patients).
- Mortality was 12%, with multiple organ failure as the leading cause.
- Exocrine insufficiency was rare, with only one case of diet-controlled hyperglycemia after extensive resection.
Conclusions:
- Distal pancreatic resection is a viable treatment for severe pancreatic trauma.
- Careful patient selection and surgical technique are crucial for minimizing complications.
- Long-term pancreatic function is often preserved despite significant resection, highlighting the pancreas's regenerative capacity.