title: Grading-therapeutic strategy for pancreatic injury after blunt abdominal trauma: therapy based on the condition of pancreatic duct and report of 95 cases.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
authors.forename: Kong
authors.initials: K
authors.lastname: Yalin
authors.forename: He
authors.initials: H
authors.lastname: Xiaojun
authors.forename: Liu
authors.initials: L
authors.lastname: Chengli
authors.forename: Zhao
authors.initials: Z
authors.lastname: Gang
authors.forename: Xiao
authors.initials: X
authors.lastname: Mei
authors.forename: Zhen
authors.initials: Z
authors.lastname: Yuying
authors.forename: Zhang
authors.initials: Z
authors.lastname: Hongyi
mesh_terms: D000007:Abdominal Injuries / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D002760:Cholangiopancreatography, Endoscopic Retrograde; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000293:injuries* / Q000601:surgery; D010183:Pancreatic Ducts / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating / Q000601:surgery*