Pancreatic trauma: A simplified management guideline

Introduction: Recent literature supports a conservative trend in the management of pancreatic injuries, Contrary to this trend, some recommend defining ductal integrity by pancreatography, implying that the results alter management. This study examines our recent 5-year experience with a simplified approach to all pancreatic injuries. Methods: Retrospective analysis of patients sustaining pancreatic injuries was performed. Results: One hundred thirty-four patients were identified, Overall mortality was 13%, and pancreatic-related mortality was 2%, Analyses were based on 124 pancreatic injuries among patients who survived >12 hours, Thirty-seven proximal injuries were treated with drainage alone, with a pancreatic morbidity of 11%. Eighty-seven distal pancreatic injuries occurred, 54 with indeterminate ductal status, Twenty-four had high probability for duct injury and were treated by distal resection; 30 with a low probability of ductal injury were drained, Pancreatic morbidity was not different between these groups. Conclusions: Pancreatic injuries including those with indeterminate ductal status can be successfully managed with low morbidity and mortality using this simplified management protocol.