Damage to the pancreas in combined traumas

Abstract

Aim. Evaluation of the possibilities of videolaparoscopy (VLS) in the diagnosis and treatment of pancreatic
injury (pancreas) in combined trauma.
Material and methods. The results of treatment of 106 patients with pancreatic injuries with combined
trauma were studied. The diagnosis of pancreatic injury was made on the basis of ultrasound diagnostics,
multispiral computed tomography (MSCT) with contrast enhancement, videolaparoscopy, laboratory results and confirmed during intraoperative revision. VLS was used in 61 (57.5%) patients, in 44 (41.5%)
cases, a wide laparotomy was performed and 1 (0.9%) patient with a small pancreatic hematoma underwent conservative treatment.
Results. VLS made it possible to exclude damage to the abdominal cavity and retroperitoneal space in 12
(19.7%) patients, in 19 (31.1%) – therapeutic laparoscopy was performed, in 30 (49.2%) – the transition
to laparotomy (conversion). In 5 patients, programmed relaparoscopy was performed through a laparoport previously installed during the first operation. Out of the total number of operated patients (n=105),
14 (13.3%) of the victims died.
Conclusion. VLS with a combined injury of the pancreas allows to reduce the number of unnecessary laparotomies and in 31.1% of cases to perform minimally invasive therapeutic interventions.