Diagnosis and treatment of |blunt pancreatic injury: a report of 32 cases
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R 657.5 

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    Abstract:

    Objective:To explore the methods for early diagnosis and treatment of  blunt pancreatic injury.
    Methods:The clinical data of 32 patients with blunt pancreatic injury treated in our hospital from Janurery 2004 to Janurery 2009 were retrospectively analyzed.
    Results:The conformity diagnosis rate of CT was 79.3%. Four cases received nonoperative treatment including 3 cases of grade  I and 1 of grade II injury. A total of 28 cases with blunt pancreatic injury underwent operation: 5 grade I and 7 grade II cases underwent debridement and drainage; among the patients with grade Ⅲ injury, 4 underwent distal pancreatectomy in combination with splenectomy, and 2 pancreatectomy with spleen preservation; amongst the 5 patients with grade Ⅳ injury, 4 underwent Roux-en-Y pancreaticojejunostomy and 1 underwent distal pancreatectomy in combination with splenectomy; of the 5 patients with grade Ⅴ injury,1 case was operated on using duodenorrhaphy and diverticulization,2 underwent the Whipple′s procedare and 2 had damage control surgery. Three patients died of multiple organ failure,and complications occurred in 19(76.0%). Pancreatic fistula and pancreatic pseudocysts were the main complications.
    Conclusions:In the absence of major pancreatic ductal injury, and the clinical conditions were stable, pancreatic injuries can be treated with nonoperative management. Operative treatment is suitable for severe blunt pancreatic injury. Appropriate operation, based on patient condition and the classification of pancrecatic trauma, is the key to increase the cure rate and decrease mortality rate.

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QIN Chang-Jiang, SUN Song-Luo, LI Shi-Jie, ZHENG Li, MA Mo-Li-. Diagnosis and treatment of |blunt pancreatic injury: a report of 32 cases[J]. Chin J Gen Surg,2009,18(9):945-947.
DOI:10.7659/j. issn.1005-6947.2009.09.015

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History
  • Received:May 26,2009
  • Revised:July 24,2009
  • Adopted:
  • Online: September 15,2009
  • Published: