title: Traumatic Transection of Pancreas at the Neck: Feasibility of Parenchymal Preserving Strategy.
abstract: BACKGROUND
  To assess the feasibility and safety of a pancreas preserving operative technique in the management of isolated complete pancreatic neck transection following blunt abdominal trauma.
  
  
  METHODS
  Two patients with isolated blunt fracture of the pancreatic neck underwent pancreas preserving procedure comprising of oversewing of the proximal pancreas and Roux-en-Y pancreatico jejunostomy to the distal remnant. A feeding jejunostomy tube was placed for postoperative nutritional support in these patients. Both patients received subcutaneous octreotide 300 µg/day.
  
  
  RESULTS
  Their ages ranged from 15 years to 20 years, mode of injury was bicycle handle-bar injury (n = 2). Both had pancreatic transection at neck in the line of superior mesenteric vessels. One had ascites. These patients had pancreas parenchyma preserving surgery - internal drainage of the left remnant in a Roux-en-Y jejunal loop. The postoperative course was uneventful in these and both are well on follow-up.
  
  
  CONCLUSIONS
  Pancreas preserving strategy - suture of head side of pancreas and an internal drainage of left remnant with a Roux-en-Y jejunal loop is feasible and safe and should be considered in selected cases. Substantial amount of normal pancreatic parenchyma is preserved.
authors.affiliation: Department of General Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Rudra Prasad
authors.initials: RP
authors.lastname: Doley
authors.affiliation: Department of General Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Thakur Deen
authors.initials: TD
authors.lastname: Yadav
authors.affiliation: Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Mandeep
authors.initials: M
authors.lastname: Kang
authors.affiliation: Government Medical College, Chandigarh, India.
authors.forename: Ashwani
authors.initials: A
authors.lastname: Dalal
authors.affiliation: Government Medical College, Chandigarh, India.
authors.forename: Mayank
authors.initials: M
authors.lastname: Jayant
authors.affiliation: Government Medical College, Chandigarh, India.
authors.forename: Rajeev
authors.initials: R
authors.lastname: Sharma
authors.affiliation: Department of General Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Jai Dev
authors.initials: JD
authors.lastname: Wig
keywords: Abdominal injuries; Organ preservation; Pancreas; Pancreatic anastomosis; Pancreatic injuries