Controversies in management of penetrating injuries of the pancreas.

The management of penetrating pancreatic injuries is still beset by controversy, especially with regard to the role of pancreatography, the most appropriate operation, the type of drainage and the adjunctive role of ocreotide. The recommendations of various experts are outlined and evaluated in the light of the authors' personal experience. Consensus is easily achieved for very minor and very severe injuries. Most management discussions center around those injuries resulting in parenchymal disruption of a degree of severity sufficient to raise doubts about the integrity of the main pancreatic duct.