title: Experience of two trauma-centers with pancreatic injuries requiring immediate surgery.
abstract: OBJECTIVE
  Pancreatic injury from blunt trauma is infrequent. The aim of the present study was to evaluate a simplified approach of management of pancreatic trauma injuries requiring immediate surgery consisting of either drainage in complex situation or pancreatectomy in the other cases.
  
  
  METHODS
  From January 1986 to December 2006, 40 pancreatic traumas requiring immediate surgery were performed. Mechanism of trauma, clinical and laboratories findings were noted upon admission, classification of pancreatic injury according to Lucas' classification were considered. Fifteen (100%) drainages were performed for stage I (n=15), 60% splenopancreatectomies and 40% drainage was achieved for stage II (n=18), 3 Pancreaticoduonectomies and 2 exclusion of duodenum with drainage and 2 packing were performed for stage IV (n=7).
  
  
  RESULTS
  There were 30 men and 10 women with mean age of 29+/-13 years (15-65). Thirty-eight patients had multiple trauma. Overall, mortality and global morbidity rate were 17% and 65% respectively, and the rates increased with Lucas' pancreatic trauma stage.
  
  
  CONCLUSIONS
  Distal pancreatectomy is indicated for distal injuries with duct involvement, and complex procedures such as pancreaticoduodenectomy should be performed in hemodynamically stable patients.
authors.affiliation: Service de Chirurgie Digestive et Oncologique, Pôle d'Oncologie et de Spécialité Médicale et Chirurgicale Hôpital Timone, Marseille, France. mehdi.ouaissi@mail.ap-hm.fr
authors.forename: Mehdi
authors.initials: M
authors.lastname: Ouaïssi
authors.forename: Igor
authors.initials: I
authors.lastname: Sielezneff
authors.forename: Jean Baptiste
authors.initials: JB
authors.lastname: Chaix
authors.forename: Remi Bon
authors.initials: RB
authors.lastname: Mardion
authors.forename: Nicolas
authors.initials: N
authors.lastname: Pirrò
authors.forename: Stéphane
authors.initials: S
authors.lastname: Berdah
authors.forename: Olivier
authors.initials: O
authors.lastname: Emungania
authors.forename: Bernard
authors.initials: B
authors.lastname: Consentino
authors.forename: Silvia
authors.initials: S
authors.lastname: Cresti
authors.forename: Laetitia
authors.initials: L
authors.lastname: Dahan
authors.forename: Pierre
authors.initials: P
authors.lastname: Orsoni
authors.forename: Vincent
authors.initials: V
authors.lastname: Moutardier
authors.forename: C
authors.initials: C
authors.lastname: Brunet
authors.forename: Bernard
authors.initials: B
authors.lastname: Sastre
mesh_terms: D000007:Abdominal Injuries / Q000145:classification / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D004322:Drainage; D004630:Emergencies; D005260:Female; D005602:France; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000145:classification / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D010179:Pancreas / Q000293:injuries*; D010180:Pancreatectomy; D010183:Pancreatic Ducts / Q000293:injuries; D016577:Pancreaticoduodenectomy; D011183:Postoperative Complications / Q000401:mortality; D011379:Prognosis; D013156:Splenectomy; D014948:Wounds, Gunshot / Q000145:classification / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D014949:Wounds, Nonpenetrating / Q000145:classification / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*