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3 "Pancreaticoduodenectomy"
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Case Reports
Pancreaticoduodenectomy as an option for treating a hemodynamically unstable traumatic pancreatic head injury with a pelvic bone fracture in Korea: a case report
Sung Yub Jeong, Yoonhyun Lee, Hojun Lee
J Trauma Inj. 2023;36(3):261-264.   Published online December 7, 2022
DOI: https://doi.org/10.20408/jti.2022.0059
  • 1,250 View
  • 28 Download
AbstractAbstract PDF
Pancreatic trauma occurs in 0.2% of patients with blunt trauma and 5% of severe abdominal injuries, which are associated with high mortality rates (up to 60%). Traumatic pancreatoduodenectomy (PD) has significant morbidity and appreciable mortality owing to complicating factors, associated injuries, and shock. The initial reconstruction in patients with severe pancreatic injuries aggravates their status by causing hypothermia, coagulopathy, and acidosis, which increase the risk for early mortality. A staging operation in which PD follows damage control surgery is a good option for hemodynamically unstable patients. We report the case of a patient who was treated by staging PD for an injured pancreatic head.
Summary
Isolated Traumatic Injury of the Pancreatic Head: A Case Report
Dong Hun Kim
J Trauma Inj. 2016;29(2):51-55.   Published online June 30, 2016
DOI: https://doi.org/10.20408/jti.2016.29.2.51
  • 2,137 View
  • 13 Download
AbstractAbstract PDF
Isolated injury to the pancreas after abdominal trauma is uncommon, and a delay in diagnosis and treatment can increase the morbidity and mortality. Therapeutic decisions with respect to pancreatic trauma are usually made based on the site of injury and the status of the pancreatic ductal system. In this report, we describe the surgical management of pancreatic head transection as an isolated injury following blunt abdominal trauma. A 55-year-old man presented with epigastric pain that radiated to the back. Abdominal computed tomography revealed a hematoma in the pancreatic head and upstream dilatation of the main pancreatic duct. Endoscopic retrograde cholangiopancreatography showed complete disruption of and contrast leakage from the main pancreatic duct in the pancreatic head region with a nonenhanced upstream duct. Emergency pancreaticoduodenectomy was successfully performed, and the patient was discharged on postoperative day 9 without any complications.
Summary
Original Article
Emergency Pancreaticoduodenectomy for Severe Pancreaticoduodenal Injury
In Kyu Park, Yoon Jin Hwang, Hyung Jun Kwon, Kyung Jin Yoon, Sang Geol Kim, Jae Min Chun, Jin Young Park, Young Kook Yun
J Trauma Inj. 2012;25(4):115-121.
  • 1,078 View
  • 13 Download
AbstractAbstract PDF
PURPOSE
Severe pancreaticoduodenal injuries are relatively uncommon, but may result in high morbidity and mortality, especially when management is not optimal, and determining the appropriate treatment is often difficult. The objective of this study was to review our experience and to evaluate the role of a pancreaticoduodenectomy (PD) in treatment of pancreaticoduodenal injuries.
METHODS
We performed a retrospective review of 16 patients who underwent an emergency PD at our hospital for severe pancreaticoduodenal injury from 1990 to 2011. Demographic data, clinical manifestations, mechanism and severity of the injury, associated injuries, postoperative complications and outcomes were reviewed.
RESULTS
The mean age of the 16 patients was 45+/-12 years (mean+/-standard deviation), and 15(93.8%) patients were male. All patients underwent an explorative laparotomy after a diagnosis using abdominal computed tomography. Almost all patients were classified as AAST grade higher than III. Thirteen(83.3%) of the 16 patients presented with blunt injuries; none presented with a penetrating injury. Only one(6.3%) patients had a combined major vascular injury. Fifteen patients underwent a standard Whipple's operation, and 1 patient underwent a pylorus-preserving pancreaticoduodenectomy. Two of the 16 patients required an initial damage-control procedure; then, a PD was performed. The most common associated injured organs were the small bowel mesentery(12, 75%) and the liver(7, 43.8%). Complications were intraabdominal abscess(50%), delayed gastric emptying(37.5%), postoperative pancreatic fistula(31.5%), and postoperative hemorrhage (12.5%). No mortalities occurred after the PD.
CONCLUSION
Although the postoperative morbidity rate is relatively higher, an emergency PD can be perform safely without mortality for severe pancreaticoduodenal injuries. Therefore, an emergency PD should be considered as a life-saving procedure applicable to patients with unreconstructable pancreaticoduodenal injuries, provided that is performed by an experienced hepatobiliary surgeon and the patient is hemodynamically stable.
Summary

J Trauma Inj : Journal of Trauma and Injury