Management of blunt pancreatic injury by applying the principles of damage control surgery: experience at a single institution

Abstract

BACKGROUND/AIMS: This study analyzes the outcomes of treatment for blunt pancreatic injuries by applying the principles of damage control surgery and discusses the management of those injuries.

METHODOLOGY: Medical records of the patients who received surgical treatment for blunt pancreatic injury during the last 30 months were investigated retrospectively.

RESULTS: A total of 23 patients were confirmed to have pancreatic injury in laparotomy during the investigation period. Based on the final surgical findings, 3 patients were classified into grade I, 9 into grade II, 7 into grade III, 2 into grade IV, and 2 into grade V by the American Association for the Surgery of Trauma - Organ Injury Scale classification. Damage control surgery was performed for 17 patients (73.9%). As a result, 8 cases of pancreatic complication, such as fistula, pseudocyst or abscess, were observed in 6 patients (26.1%). Three patients died with a mortality rate of 13.0%. The causes of death were hemorrhage in other organs and multiple organ failure.

CONCLUSIONS: For a good prognosis, the first operation time after injury should be decreased and surgical technique should be simplified by damage control surgery to reduce complications as well as to prevent exacerbation of the general condition in patients with major pancreatic injury.