Pancreatic damage control: the pancreas is simple don't complicate it

Area of Science:

• Trauma Surgery
• Surgical Management
• Abdominal Injuries

Background:

• Pancreatic trauma is rare, potentially lethal, and often associated with other injuries.
• Delayed presentation complicates diagnosis and management of pancreatic injuries.
• Lack of consensus exists regarding optimal diagnosis and treatment strategies for pancreatic trauma.

Purpose of the Study:

• To propose an expert consensus-based management algorithm for pancreatic injuries.
• To emphasize organ preservation and minimize complications.
• To guide surgeons in the efficient diagnosis and management of pancreatic trauma.

Main Methods:

• Development of a management algorithm based on expert consensus.
• Review of current surgical trends and principles of damage control surgery.
• Application of hemostatic maneuvers, pancreatic packing, suturing, and drainage.

Main Results:

• Most pancreatic injuries can be managed non-resectively.
• Distal pancreatectomies should be avoided to preserve pancreatic tissue.
• Damage control principles followed by definitive management upon patient stabilization are recommended.

Conclusions:

• Organ preservation is key in managing pancreatic trauma.
• Non-resective techniques with adequate drainage are preferred.
• The proposed algorithm aims to decrease short- and long-term morbidity by preserving pancreatic function.