Experience of two trauma-centers with pancreatic injuries requiring immediate surgery.
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.
Ouaïssi
Mehdi
M
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
Sielezneff
Igor
I
Chaix
Jean Baptiste
JB
Mardion
Remi Bon
RB
Pirrò
Nicolas
N
Berdah
Stéphane
S
Emungania
Olivier
O
Consentino
Bernard
B
Cresti
Silvia
S
Dahan
Laetitia
L
Orsoni
Pierre
P
Moutardier
Vincent
V
Brunet
C
C
Sastre
Bernard
B
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*