Management of pancreatic trauma.

Between 1974 and 1984, 25 patients with pancreatic trauma were seen at three Regina hospitals. Eighteen had blunt injuries and 7 penetrating injuries. The mean injury severity score was 37 and the mean age 24.5 years. Management was nonoperative in six patients. Of the 19 treated surgically, 14 underwent laparotomy and drainage, 2 laparotomy without drainage and 3 pancreatic resection. Complications related to pancreatic injury occurred in 11 patients. One patient died. The results of this series suggest that the majority of patients with pancreatic injuries can be treated by laparotomy and drainage with a low mortality, but the complication rate is high. In select patients, visualization of the pancreatic duct may allow the surgeon to perform definitive surgical management at the initial procedure.