Pancreatographic Classification of Pancreatic Ductal Injuries Caused by Blunt Injury to the Pancreas

Takishima, T; Hirata, Mitsuho; Kataoka, Yuichi; Asari, Yasushi; Sato, Koshi; Ohwada, Takashi; Kakita, Akira

doi:10.1097/00005373-200004000-00026

Cited by 64 publications

(38 citation statements)

References 9 publications

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“…A retrospective study performed by a Japanese group [16], analyzing the treatment of pancreatic lesions according to preoperative ERCP findings, revealed a similar conclusion [16]. These authors suggest that patients with radiographically normal ducts or with branch injuries which do not leak can be treated conservatively, while branch injuries with leaks into the retroperitoneal space require surgical drainage, and disruption of the major pancreatic duct also necessitates surgical repair.…”

Section: Discussionmentioning

confidence: 89%

“…ERCP is an elegant tool in assessing the integrity of the pancreatic duct. Additionally, ERCP offers the possibility for minimally invasive therapeutic interventions, like ductal stenting, especially in cases of partial ductal rupture [16, 17]. However, ERCP and ERCP-assisted interventions may be useful in the conservative treatment of ductal injuries, but as primary diagnostic tools in the emergency situation, they are often not available or too time-consuming.…”

Section: Discussionmentioning

confidence: 99%

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Pancreatic Injury in Severe Trauma: Early Diagnosis and Therapy Improve the Outcome

Mayer

Tomczak²,

Rau³

et al. 2002

Dig Surg

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Background: Pancreatic injury is a dangerous complication in multiple injury, and experience with its diagnosis and treatment is usually limited. Method: Retrospective analysis of 3,840 patients admitted after multiple trauma from January 1, 1982, until May 31, 2000. Results: A laparotomy was performed in 121 cases (3.15%) due to suspected intra-abdominal lesion. 32% of the patients (39/121) had a pancreatic lesion; 23% (9/39) had a rupture of the major pancreatic duct. Primary laparotomy was performed in 72% of the patients (28/39). Superficial lesions were treated by explorative laparotomy alone (n = 7), debridement and external drainage (n = 20), or necrosectomy and lavage (n = 3). Complex pancreatic lesions were treated by pancreatojejunostomies (n = 5), pancreatic left resections (n = 2), or exploration alone (n = 2). 8 of 39 patients died (20%), 4 intraoperatively. Of the surviving 35 patients, a pancreas-associated complication developed in 8 patients (23%): pancreatic abscesses (n = 4), traumatic pancreatitis (n = 3), pancreatic fistulas (n = 2), and pseudocysts (n = 2). Conclusions: Pancreatic injury is an infrequent but dangerous complication in severe trauma. Superficial lesions not affecting the major pancreatic duct can be managed by debridement and external drainage. If the major pancreatic duct is ruptured, organ-preserving, complex reconstructive procedures are necessary. When diagnosed timely and treated according to severity and overall situation, pancreatic injuries have an acceptable morbidity, but usually a high mortality.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Pancreatic Injury in Severe Trauma: Early Diagnosis and Therapy Improve the Outcome

Mayer

Tomczak²,

Rau³

et al. 2002

Dig Surg

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show abstract

“…Chronic renal failure may be a risk factor, and contrast medium leaking into the retroperitoneal space is another one. When contrast medium has leaked into retroperitoneal space or even into peritoneal cavity, the injury is more serious and operation is suggested [18]. Stenting may delay operation.…”

Section: Discussionmentioning

confidence: 99%

Long-term results of endoscopic stent in the management of blunt major pancreatic duct injury

Lin¹,

Liu²,

Fang³

et al. 2006

Surg Endosc

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Stent therapy may avoid surgery in the acute trauma stage, and may be preserved as another choice for acute grade IV pancreatic injury. However, variant outcome and long-term ductal stricture reveal that the role of pancreatic duct stent is uncertain and may not be suitable for acute grade III pancreatic injury. However, it needs more clinical data to define the value in the acute blunt pancreatic duct injury.

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“…In one study, an early ERP group (<72 h) was found to have significantly less pancreas-related complications than a later ERP group (>72 h) [10]. Positive results of stent implantation in cases of pancreatic injuries involving both children and adults have been reported [17,20].…”

Section: Discussionmentioning

confidence: 99%

“…Table 3. Classification of pancreas injuries by Takishima et al [17] Degree Description I Radiographic normal DP II Injuries to the junction of the DP a Contrast medium is inside the parenchyma b…”

Section: Discussionmentioning

confidence: 99%

The value of endoscopic diagnosis and the treatment of pancreas injuries following blunt abdominal trauma

et al. 2005

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Pancreatographic Classification of Pancreatic Ductal Injuries Caused by Blunt Injury to the Pancreas

Abstract: This classification system for pancreatic ductal injuries may facilitate the selection of appropriate therapeutic modalities for patients with blunt pancreatic injury.

Cited by 64 publications

References 9 publications

Pancreatic Injury in Severe Trauma: Early Diagnosis and Therapy Improve the Outcome

Pancreatic Injury in Severe Trauma: Early Diagnosis and Therapy Improve the Outcome

Long-term results of endoscopic stent in the management of blunt major pancreatic duct injury

The value of endoscopic diagnosis and the treatment of pancreas injuries following blunt abdominal trauma

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