[Traumatic injuries of the pancreas]

Retrospective analysis of surgical treatment of 153 patients with traumatic damage to the pancreas is discussed. The injury was closed in 67.3% and open in 32.7% of cases. All cases were grouped in 4 degrees of severity: 1st degree--contusion of the gland without damage to the capsule (22.2%); 2nd degree--rupture of the gland without injury to the pancreatic duct (34.6%); 3rd degree--rupture of the gland with damage to the duct; 4th degree--combined pancreatoduodenal injury (15.7%). The therapeutic tactics was determined by the degree of injury inflicted to the pancreas. In 1st degree operation on the pancreas was not needed. In 2nd and 3rd degrees "abdominization" with drainage was the operation of choice. Distal resection was expedient only in crushing of the organ. The tactics in pancreatoduodenal injuries depended on the character of the duodenal wound. Thirty-nine (25.5%) patients died, 24 (61.5%) of them died in the first two postoperative days from shock. Pancreatitis was the prevailing postoperative complication, it occurred in 41 (31.8%) patients. All patients with injuries to the pancreas should be managed as cases of potential pancreatitis.