Pancreatoduodenectomy for penetrating pancreatic trauma.

Six cases of pancreatoduodenectomy performed for combined injuries of the pancreas, duodenum, and/or distal common duct are reported. Pancreatoduodenectomy is indicated when there is extensive destruction of the pancreatic head in conjunction with major injuries of the duodenum, distal common duct, and/or retropancreatic portal vein, necessitating complete division of the pancreatic head. Reconstruction is best achieved by end-to-end pancreatiocieiunostomy, end-to-side choledochojejunostomy, antrectomy, and vagotomy.