Individual management for pancreas injuries of 40 cases

Objective To discuss the individual management for the injuries of pancreas. Method Forty patients with injuries of pancreas treated during the last 10 years in our hospital, were analyzed retrospectively for the surgical treatment and their clinical results. Results Twelve cases were treated by conservative treatment, and 28 cases were treated by operation. Simple closed suction drainage near the pancreatic bed was performed in 6 patients. Debridement, suture and closed suction drainage were performed in 11 patients. Ultrasound guided percutaneous catheter drainage was performed in 3 patients. Distal pancreatectomy was performed in 4 patients. Resection of the right side of the liver, the distal pancreas and the spleen was performed in 1 patient. Pancreaticogastrostomy and jejunum stoma were performed in 1 patient. Pancreatoduodenectomy was performed in 1 patient. Repair of the liver, the common bile duct, the duodenum, and the pancreas, combined with jejunum stoma and gastrostomy were performed in 1 patient. Thirty-eight patients were cured, and 2 patients died. Pancreatic fistula occurred in 4 cases. Conclusions The principle of individualization is the key to improve the effect of treatment according to the characteristics of trauma. Ultrasound guided percutaneous catheter drainage and pancreaticogastrostomy provide a new way for the injuries of pancreas. Key words: Abdominal injuries; Pancreas; Treatment; Pancreatic fistula