TREATMENT of the injured pancreas is the most difficult and controversial problem in surgery of abdominal trauma. Several clinical and experimental studies support the use of measures which depress gastric and pancreatic secretions and maintain blood volume, as well as those procedures intended to inhibit the diffuse "inflammatory" changes which may occur.
When serious damage is confined to the body or tail of the gland, the resection of detached or devitalized fragments is an accepted method of treatment to assure hemostasis and reduce the frequency of late complications. Injury of that portion of the pancreas to the right of the superior mesenteric vessels, however, introduces concern for the integrity of the duodenal wall and the biliary and pancreatic ductal systems, and it is in this area that surgical measures to repair or resect pancreatic tissue take on awesome proportions.
Our experience with seven patients who sustained disruption of the head
ROBERT J. FREEARK, JAMES M. KANE, FRANK A. FOLK, ROBERT J. BAKER. Traumatic Disruption of the Head of the Pancreas. Arch Surg. 1965;91(1):5–13. doi:10.1001/archsurg.1965.01320130007002