[Damage control surgery for pancreatic injuries after blunt abdominal trauma].
OBJECTIVE
To summarize the management of pancreatic injuries after blunt abdominal trauma.


METHODS
The clinical data of 42 patients with blunt pancreatic injury admitted from January 2001 to December 2010 was analyzed retrospectively. There were 38 male and 4 female patients, aging from 13 to 65 years with a mean of 31 years. The organ injury scaling of Committee of the American Association for the Surgery of Trauma (AAST grade): grade I in 3 patients, grade II in 12 patients, grade III in 9 patients, grade IV in 13 patients and grade V in 5 patients. The mean injury severity score was 27 ± 21. Patients above AAST grade II underwent peritoneal drainage and "three neostomy" (gastrostomy, jejunostomy and gallbladder) according to damage control theory.


RESULTS
Thirty-eight patients got abdominal CT scanning with a positive rate of 79.9% (30/38). Forty patients underwent surgical procedures, and 2 patients with non-operative management. The surgical procedures include peritoneal drainage and "three neostomy" in 32 patients, pancreas suture or pancreatic tail resection in 6 patients, pancreatoduodenectomy or caudal pancreaticojejunostomy in 2 patients. Forty patients (95.2%) survived, 2 patients (4.8%) died and 16 patients (38.1%) had complications such as pancreatic fistula,pulmonary infection.


CONCLUSIONS
Abdominal CT scanning will benefit the preoperative diagnosis of blunt pancreatic trauma. Although the survival rate of patients with blunt pancreatic trauma might be improved by using the damage control surgery, the management of damage control surgery also needs to be modified because of the high rate of complications.
Research Institute of General Surgery, Clinical School of Medical College of Nanjing University, Nanjing General Hospital of Nanjing Military Command, Nanjing 210002, China.
Zhen-guo
ZG
Zhao
You-sheng
YS
Li
Jian
J
Wang
Gang
G
Li
Kai
K
Wang
Zi-wei
ZW
Xu
Lei
L
Zheng
Ning
N
Li
Jie-shou
JS
Li
D000293:Adolescent; D000328:Adult; D000368:Aged; D004322:Drainage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000293:injuries* / Q000601:surgery; D012189:Retrospective Studies; D014949:Wounds, Nonpenetrating / Q000601:surgery*; D055815:Young Adult