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Lessons learned from isolated blunt major pancreatic injury: Surgical experience in one trauma centre

Injury May 31, 2019

Lin BC, et al. - Researchers retrospectively studied 31 patients with isolated blunt major pancreatic injury (IBMPI) and 54 patients with multi-organ injury, who underwent surgery in order to report their surgical experience of IBMPI, and to compare its characteristic outcomes with that of multi-organ injury. Outcomes revealed longer injury-to-surgery times (median, 36.0 h) for patients with IBMPI vs those with multi-organ injury; the most common contributor to delayed surgery was delayed medical visit reflecting the unique character of the retroperitoneal organ. They noted high surgical complication rates among patients with blunt major pancreatic injury, regardless of whether the injury was isolated or multi-organ. Pancreatic duct stent placement is suggested as an adjunctive therapy for postoperative pancreatic fistula for IBMPI patients with partial major pancreatic duct (MPD) injury; however, in complete MPD injury, pancreatectomy is warranted. The time interval from injury to surgery was identified as a significant associated factor in preserving or sacrificing the spleen for patients with IBMPI who underwent distal pancreatectomy.
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