Management Of Severepancreatic Injury

Objective:To investigate the principle and function of damage control surgery in management of severe pancreatic injury and its complications.Methods:A retrospective review was performed of the medical records of 5 patients who underwent surgery in Chinese PLA General Hospital (Beijing, China) between January 2000 and December 2014. Study the practicality and long-term efficacy of "bridge" pancreaticgastric anastomosis in animal experiment.Results:1. Three of five patients underwent damage control surgery in the emergency operative room and survived, whereas the other 3 who have pancreaticoduodenectomy died. A patient received a new damage control surgery, "bridge" pancreaticgastric anastomosis, and got a wonderful outcome.2. Thereful, an animal experiment on this new anastomosis was performed. There was no pancreatic fistula in the early days after surgery, whereas the stenosis of pancreaticgastric anastomosis occurred in all modeled animals.3. Eight patients received the percutaneous nephroscopic necrosectomy and it succeeded in all patients. There were no deaths or surgical-related complications. And 2 patients have open necrosectomy and massive hemorrhage complication occurred in one patient.Conclusion:Damage control principle and technique should be applied in the emergency surgery, "bridge" pancreaticgastric anastomosis, as a new damage control surgical Technique, should be more applied in the treatment of severe pancreatic injury. The percutaneous Nephroscopic necrosectomy procedure is a safe and applicable alternative treatment for infected pancreatic necrosis after pancreatic injury.