Damage control management of combined pancreatoduodenal injuries with serious injuries

Objective To explore the effects of damage control operation (DCO) of combined pancreatoduodenal injuries with serious trauma.Methods Clinical data of 4 cases of pancreatoduodenal injuries during a 5-year period were analyzed retrospectively according to the effects of active DCO.Results Assessment of Injury Severity Score was studied and greater than 16.Four patients who presented in physiologic extremes were subjected to damage control laparotomy because of the severity of the associated injuries and severe pancreatoduodenal injuries.The primary operative approach was damage control,including bleeding control,control of enteral spillage,Whipple operation without reconstituted digestive tract,temporary abdominal wall closure and drainage of the injured pancreas and duodenum.Definitive procedures should be performed after hemodynamic stabilization in SICU for up to 48?h.All cases were cured.Conclusion DCO and a stage approach to reconstruct digestive tract are beneficial to the combined pancreatoduodenal injuries who who are in extremes.The DCO has a significantly lower mortality rate in the patients with pancreatoduodenal injuries.