PANCREATIC TRAUMA - A SIMPLIFIED MANAGEMENT GUIDELINE

Introduction: Recent literature supports a conservative trend in the m anagement of pancreatic injuries, Contrary to this trend, some recomme nd defining ductal integrity by pancreatography, implying that the res ults alter management. This study examines our recent 5-year experienc e with a simplified approach to all pancreatic injuries. Methods: Retr ospective analysis of patients sustaining pancreatic injuries was perf ormed. Results: One hundred thirty-four patients were identified, Over all mortality was 13%, and pancreatic-related mortality was 2%, Analys es were based on 124 pancreatic injuries among patients who survived > 12 hours, Thirty-seven proximal injuries were treated with drainage al one, with a pancreatic morbidity of 11%. Eighty-seven distal pancreati c injuries occurred, 54 with indeterminate ductal status, Twenty-four had high probability for duct injury and were treated by distal resect ion; 30 with a low probability of ductal injury were drained, Pancreat ic morbidity was not different between these groups. Conclusions: Panc reatic injuries including those with indeterminate ductal status can b e successfully managed with low morbidity and mortality using this sim plified management protocol.