title: Diagnostic Use of Endoscopic Retrograde Cholangiopancreatectography for Pancreatic Duct Injury in Trauma Patients.
abstract: BACKGROUND
  Trauma patients diagnosed with pancreatic duct injury (PDI) have a high complication rate and prolonged hospital stay. The role of endoscopic retrograde cholangiopancreatography (ERCP) in the diagnosis of PDI remains unclear. During the last decade, our trauma unit incorporated ERCP into the management protocol for suspected PDI cases.
  
  
  OBJECTIVE
  To determine whether ERCP is a sensitive tool to detect PDI.
  
  
  METHODS
  This retrospective trauma patient series study assessed the diagnostic yield of ERCP in trauma cases with suspected PDI on computed tomography (CT) or intraoperatively. Between 1 January 2004 and 31 December 2011, 13 patients admitted to our medical center underwent ERCP for suspected PDI. Patient demographics, mechanism of injury, Injury Severity Score (ISS), time from injury to ERCP, and ERCP-related complications were documented and assessed.
  
  
  RESULTS
  Of the 13 patients included in the analysis, 8 stable patients with suspected PDI on CT had no leak from the main pancreatic duct on ERCP. Two of them underwent surgery for suspected pancreatic transection. ERCP confirmed a main pancreatic duct leak in three patients. Two patients underwent ERCP for suspected PDI after "damage control" surgery. No leak from the pancreatic ducts was diagnosed. No pancreas-related complications or ERCP-related complications were observed.
  
  
  CONCLUSIONS
  ERCP is a sensitive and relatively safe tool for the diagnosis of PDI, and its use might prevent unnecessary surgical interventions in selected trauma cases.
authors.forename: Igor
authors.initials: I
authors.lastname: Jeroukhimov
authors.forename: Itay
authors.initials: I
authors.lastname: Zoarets
authors.forename: Itay
authors.initials: I
authors.lastname: Wiser
authors.forename: Zahar
authors.initials: Z
authors.lastname: Shapira
authors.forename: Dov
authors.initials: D
authors.lastname: Abramovich
authors.forename: Vladimir
authors.initials: V
authors.lastname: Nesterenko
authors.forename: Ariel
authors.initials: A
authors.lastname: Halevy
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods*; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D010183:Pancreatic Ducts / Q000293:injuries*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014947:Wounds and Injuries / Q000175:diagnosis* / Q000473:pathology; D055815:Young Adult