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Operative strategies in pancreatic trauma
R J Farrell1, J E Krige, P C Bornman
1Department of Surgery, University of Cape Town, South Africa.
The British Journal of Surgery
|July 1, 1996
Summary
This study reviewed 51 pancreatic trauma cases, finding stab wounds often manageable with drainage. Blunt trauma and gunshot wounds require careful exploration due to common duct injuries.
Area of Science:
- Trauma Surgery
- Surgical Management
- Gastrointestinal Surgery
Background:
- Pancreatic injuries are rare and challenging to manage.
- Surgical decisions for pancreatic trauma require careful consideration.
Purpose of the Study:
- To review operative procedures for pancreatic trauma.
- To analyze outcomes based on injury type and surgical approach.
Main Methods:
- Retrospective review of 51 patients with pancreatic trauma (Jan 1990 - Jun 1993).
- Categorization by injury mechanism (blunt, gunshot, stab) and location (head, body, tail).
- Analysis of surgical interventions (pancreatoduodenectomy, distal pancreatectomy, drainage) and outcomes.
Main Results:
- 51 patients studied: 13 blunt, 17 gunshot, 21 stab wounds.
- 10% mortality rate (5/51), primarily from hemorrhage and multiple organ failure.
- 20% pancreatic fistula rate (10/51), mostly after drainage procedures.
Conclusions:
- Stab wounds have low duct injury incidence; external drainage is often sufficient.
- Blunt trauma and gunshot wounds frequently involve duct injuries requiring meticulous surgical exploration.
- Pancreatic resection can yield good results in selected patients with severe pancreatic trauma.