Our decade experience of the diagnosis and treatment of closed pancreatic injuries
Abstract
Background. To this day, there is no consensus on the optimal therapeutic and diagnostic algorithm for patients with closed pancreatic trauma when emergency surgery is required. Objective. The aim of this study to determine the method of diagnostics and surgical intervention in traumatic injuries of the pancreas. Material and methods. The results of 125 patients with pancreas injuries during the decade were analyzed. Men prevailed among the patients (83.2%), with the age from 20 to 60. Two groups of patients were formed: Group I included 84 patients from 2011 to 2016, who have undergone traditional surgery. Group II included 41 patients from 2016 to 2021, who have undergone endovideo surgical techniques for diagnosis and treatment. Results. Among the II group of patients there were 12 patients with grade I pancreatic injury. Open surgery — laparotomy was performed in 6 of them, and videolaparoscopy was performed in another 6 patients. There were no significant differences in the number of complications in patients who underwent laparotomy and laparoscopy. This testifies to the fact that both methods allow to make an adequate revision of the abdominal cavity and to establish the diagnosis. Conclusion. In our opinion, a laparoscopy can be used for isolated lesions of the pancreas and only for AAST grade I lesions. In grade II lesions it is better to end the operation with precision hemostasis. In grade III pancreatic lesions, distal resection should be performed. The tactics of surgical treatment in pancreatic injuries depends on the degree of its traumatization.