Traumatic pancreatic duct injury in children: minimally invasive approach to management

Paediatric pancreatic trauma: A review of the literature and results of a multicentre survey on patient management:

“…The management of grade I and II injuries is less controversial, and conservative management is agreed as the standard of care. [1,3,7,8,10] Treatment becomes less clear and more controversial when ductal injury is suspected (grades III -V). Some authors advocate conservative management irrespective of the grade of the injury, [1,5,6,11] while others opt for an aggressive surgical approach if the diagnosis is made early on, preferring distal pancreatectomy with splenic preservation.…”

“…[7] Despite these risk factors, blunt pancreatic trauma is relatively rare, with a reported incidence ranging from 0.3% to 0.7% of admissions for blunt abdominal trauma. [7,8] This makes it difficult for individual centres to research management protocols owing to the limited number of cases, and the largest series are based on retrospective multicentre data collection and review. [3,4,9] Owing to the frequently relatively benign presentation of the patient, many of these injuries are initially overlooked and presentation is therefore delayed, potentially causing severe morbidity and even mortality in some cases.…”

Stumpe pancreasskader hos barn

“…ERCP involving insertion of a stent is regarded as a non-surgical treatment method (9,20,28,35,36), although this is an intervention which, among other things, is associated with an increased risk of pancreatitis. Stent treatment may reduce leakage of pancreatic secretions into the pancreatic cavity (in cases of pseudocyst or pancreatic fistula).…”

Traumatic Pancreatitis - Endoscopic and Surgical Management

“…Recently, ERCP has been shown not only to provide sufficient information for conclusive diagnosis but also to be an effective and safe non-operative treatment tool (Bendahan et al, 1995;Huckfeldt et al, 1996;Kim et al, 2001;Cay et al, 2005;Houben et al, 2007). In certain cases of leakages of the pancreatic duct, transpapillary stent insertion might seal the injury and stabilize it in a way that eventually leads to resolution of the leakage…”

“…Transductal pancreatic stent allows internal drainage of the pancreatic secretion and re-establishment of duct continuity (Bendahan et al, 1995;Huckfeldt et al, 1996;Cantly et al, 2001;Kim et al, 2001;Lin et al, 2006;Houben et al, 2007;Rogers et al, 2009). …”