Objective: To assess the value of abdominal vacuum sealing drainage (VSD) in treatment of severe pancreatic-duodenal injuries. Methods: The clinical data of 16 patients with severe pancreatic-duodenal injury admitted during January 1998 and January 2013 were retrospectively analyzed. Injuries of the patients were graded according to AAST injury grading system as grade III in 10 cases, grade IV in 4 cases, and grade V in 2 cases, respectively. Results: The patients were subject to only debridement and hemostasis of wound surface for pancreatic lacerations, one-layered suture closure of duodenal lacerations, relevant treatments for the associated injuries, and then VSD of the area around the pancreatic transection and duodenal injury. The operative time ranged from 65 to 235 min with an average of 126 min. There was no operative death, while one patient was transferred to another hospital due to abdominal bleeding after operation, and the length of hospital stay for abdominal injury in the remaining 15 cases ranged from 16 to 45 d. Of the patients with grade III injury, postoperative duodenal fistula occurred in 5 cases and pancreatic fistula occurred in 3 cases, and all of them closed spontaneously after VSD. In patients with grade IV and V injury, pancreatic and duodenal secretions were continuously drained from VSD tube until the formation of a complete fistula tract around the VSD tube, and then a Roux-en-Y anastomosis between the fistula tract and jejunum was performed. Follow-up was variable from 6 months to 15 years, during which, no complications such as intra-abdominal infections, abdominal effusion, pancreatic pseudocyst, or intestinal obstruction were noted. Conclusion: For patients with severe pancreatic-duodenal injury who are in critical condition, or would not tolerate complex surgery, simple treatment of the pancreatic-duodenal wound surface combined with VSD is recommended.