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April 1973

Pancreatic InjuriesMethods of Management

Author Affiliations

San Francisco
From the Surgical Service, University of California School of Medicine at San Francisco General Hospital.

Arch Surg. 1973;106(4):544-549. doi:10.1001/archsurg.1973.01350160156026

Approximately two thirds of 85 cases of traumatic injury to the pancreas resulted from penetrating injury and one third from blunt injury. The current method of management includes drainage alone for injuries that do not involve major ductal structures, and pancreatic resection for those that do. The key to treatment is accurate evaluation of the extent of injury. Methods of exploration and assessment of the ductal injury are described. The rate of associated injury is high (85%) and accounts in large part for the mortality. Concomitant pancreatic and devascularizing duodenal injuries are particularly difficult to manage.

There were 23 deaths (27%). In 13 patients without associated injury, there was only one death. The pancreatic wound gives rise to complications of fistula, pancreatitis, and pancreatic pseudocyst. There were 20 such complications in these patients.