title: Surgical reconstruction and endoscopic pancreatic stent for traumatic pancreatic duct disruption.
abstract: Nonoperative management is acceptable treatment for minor pancreatic injuries. However, management of major pancreatic duct injury in children remains controversial. We present our experience in treating isolated pancreatic duct injury. We describe the cases of three male patients treated for complete pancreatic duct disruption in the past 5 years at our institution. We performed pancreatic duct repair to avoid distal pancreatectomy and to maintain normal pancreatic function. All patients underwent enhanced computed tomography and endoscopic retrograde cholangiopancreatography in the early period. The injuries were classified as grade III according to the American Association for the Surgery of Trauma classification. In two cases, we performed end-to-end anastomosis of the pancreatic duct during the delayed period. In the third case, we placed a stent across the disruption to the distal pancreatic duct. The patients' postoperative courses were uneventful, and the average hospitalization was 25.6 days after the procedure. At a median follow-up of 36 months (range 14-54 months), all patients remain asymptomatic, with normal pancreatic function, but with persistent distal pancreatic duct dilatation. We suggest that distal pancreatectomy should not be routinely performed in patients with isolated pancreatic duct injury.
authors: Division of Pediatric Surgery, Department of Surgery, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
authors: Insu
authors: I
authors: Kawahara
authors: Kosaku
authors: K
authors: Maeda
authors: Shigeru
authors: S
authors: Ono
authors: Hiroshi
authors: H
authors: Kawashima
authors: Ryoichi
authors: R
authors: Deie
authors: Satohiko
authors: S
authors: Yanagisawa
authors: Katsuhisa
authors: K
authors: Baba
authors: Yoshiko
authors: Y
authors: Usui
authors: Yuki
authors: Y
authors: Tsuji
authors: Atsuhisa
authors: A
authors: Fukuta
authors: Sachi
authors: S
authors: Sekine
mesh_terms: D000293:Adolescent; D002648:Child; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods; D004724:Endoscopy; D016145:Endoscopy, Digestive System / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010183:Pancreatic Ducts / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D015607:Stents; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging / Q000601:surgery*