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Updated: Feb 8, 2026

Author Spotlight: Advancements in Retroperitoneal Approach for Necrotizing Pancreatitis
Published on: March 15, 2024
Combination therapy with early nasopancreatic drainage and minimum surgery for blunt high-grade pancreatic trauma
Makoto Takaoka1, Masayoshi Ono2, Chika Kunishige2
1Himeji Emergency Trauma and Critical Care Center Steel Memorial Hirohata Hospital Himeji Hyogo Japan.
Case:
A 22-year-old man suffered blunt, high-grade, pancreatic trauma; however, duct-related complications were avoided by combining early nasopancreatic drainage with minimal surgery. Endoscopic retrograde pancreatography confirmed rupture of the main pancreatic duct and massive retroperitoneal extravasation. A nasopancreatic catheter was placed across the rupture site, laparotomy was carried out, and a grade IV pancreatic head laceration was sutured. Because the nasopancreatic catheter shifted out intraoperatively, another was inserted and left in place for 12 days.
Outcome:
The patient recovered well without any duct-related complications such as pseudocyst or external pancreatic fistula.
Conclusion:
A combination of early therapeutic endoscopic retrograde pancreatography and surgical repair may be useful for treating high-grade pancreatic trauma when pancreatic resection is unnecessary.
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