Ann Hepatobiliary Pancreat Surg.  2019 Nov;23(4):408-413. 10.14701/ahbps.2019.23.4.408.

Laparoscopic distal pancreatosplenectomy for isolated blunt traumatic pancreatic laceration: A case report and review of current literature

Affiliations
  • 1Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore. bsgkp@hotmail.com
  • 2Duke-National University of Singapore (NUS) Medical School, Singapore.

Abstract

Pancreatic injuries are often associated with trauma and occur most commonly in combination with other solid organ injuries. Management strategies for pancreatic injuries include conservative, endoscopic, percutaneous and surgical intervention. Literature on the laparoscopic approach to management of pancreatic trauma is rare and poorly reviewed. We describe a case report of successful and uncomplicated laparoscopic distal pancreatosplenectomy (LDP) for a patient suffering from isolated traumatic pancreatic tail transection. A literature review was performed with regards to the indications for intervention and different modalities of treatment for traumatic pancreatic lacerations. A review and comparison was also made between the scarce pre-existing reports of the laparoscopic approach to pancreatic resection in the setting of trauma. The laparoscopic approach to pancreatic resection, in the setting of trauma, can be considered as a viable alternative to open surgery. Moving forward, further studies with larger patient numbers will be needed to compare the outcomes between the open and laparoscopic approach.

Keyword

Pancreas; Wounds and injuries; Laparoscopy; Pancreatectomy

MeSH Terms

Humans
Lacerations*
Laparoscopy
Pancreas
Pancreatectomy
Tail
Wounds and Injuries

Figure

  • Fig. 1 CT abdomen pelvis showing a discrete linear wedge-shaped cleft of hypoattenuation at the junction of the body and tail of the pancreas in keeping with an 80% laceration through the pancreas, and an associated complete transection of the main pancreatic duct.

  • Fig. 2 CT abdomen pelvis showing a hyperdense focus within the wedge-shaped laceration representing a hematoma.


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