[Surgical management of blunt pancreatic trauma]

From 1986 to 1990, 22 patients with blunt pancreatic trauma were hospitalized and operated on in Kuang Tien General Hospital. Included were 19 males and 3 females with a mean age of 31 years (range: 2 to 58). The mean duration of the follow-up was 42 months. We classified the severity of pancreatic injury with the pancreatic organ injury scale which was published by the Organ Injury Scaling (O.I.S.) Committee of the American Association for the Surgery of Trauma (A.A.S.T.) in 1990. According to the operative findings, the pancreatic injury of the 22 cases were classified as follows: grade I 8 cases, grade II 9 cases, grade III 4 cases, grade IV 1 case, and no grade V pancreatic injuries. Among the patients, 12 cases were treated with drainage. Seven cases underwent repair and drainage. Three cases were treated with distal pancreatectomy. The mortality rate was 18.2%, and the morbidity rate 40.9%. The most frequent postoperative complications related to the pancreatic injury in the patients who survived the initial operation were pancreatic fistula (13.7%), small bowel obstruction (9.2%), intraabdominal abscesses (4.5%), wound infection (4.5%), pancreatitis (4.5%), and pseudocyst (4.5%).