Grading-therapeutic strategy for pancreatic injury after blunt abdominal trauma: therapy based on the condition of pancreatic duct and report of 95 cases.

BACKGROUND/AIMS: Pancreatic injury after blunt abdominal trauma is always associated with a high morbidity and mortality. The purpose of this study was to evaluate the effect of a grading-therapeutic strategy and to highlight various challenges in the management of blunt pancreatic injury.

METHODOLOGY: All cases of pancreatic injury after blunt abdominal trauma from January 1, 2008, to December 30, 2012, were retrospectively reviewed, and the clinical data were collected.

RESULTS

Ninety-five patients formed the group, out of which 76 (80.0%) undertook operative management, 19 (20.0%) undertook non-operative management; 18 underwent ERCP for pancreatic duct evaluation, with 7 (38.9%) undergoing nasopancreatic drain placement and 4 (22.2%) transpapillary pancreatic duct stent placement. Operation was performed for patients according to pancreatic injury grading and results of intra-operative selective pancreatography. Twenty-three (30.3%) developed various pancreatic-related complications.

CONCLUSIONS

Grading-therapeutic strategy for blunt pancreatic injury based on condition of the pancreatic duct could be performed safely and effectively. It not only expanded the scope of non-operative management, but also preserved the normal pancreatic tissue.