J Korean Soc Traumatol.  2011 Dec;24(2):136-142.

The Role of Endoscopic Retrograde Cholangiopancreatography (ERCP) in the Treatment of Traumatic Pancreas Injury

• Jeong MY
• Kim YH
• Kyoung KH
• Lee SK
• Hong SK

Abstract

PURPOSE
Blunt pancreatic injury has a high mortality rate, especially if adequate management is delayed. Although many guidelines exist for diagnosis and treatment, there is no consensus to date. Therefore, we analyzed the role of endoscopic retrograde cholangiopancreatography (ERCP) as a diagnostic and therapeutic tool for the treatment of traumatic pancreatic injury.
METHODS
We retrospectively reviewed the electronic medical records (EMR) database at Asan Medical Center (Seoul, South Korea) to identify all patients diagnosed with trauma to the pancreas between June 2003 and December 2010. Clinical and operative findings, CT (computed tomography) images, and ERCP findings were assessed.
RESULTS
A total of 40 patients were evaluated in this study. Of these, 14 patients underwent diagnostic ERCP, and 26 did not. Of the 14 patients who underwent diagnostic ERCP, 5 were found to have normal pancreatic ducts, thereby preventing a needless laparotomy in these patients. Of the patients diagnosed with ductal injury, four were treated with endoscopic intervention, and four underwent an exploratory laparotomy. The remaining patient was treated with radiologic intervention (percutaneous drainage) to manage pancreatic pseudocyst formation.
CONCLUSION
Our findings suggest that ERCP is a beneficial diagnostic and therapeutic modality for the treatment of traumatic pancreatic injury.

Keyword

Pancreatic duct; Endoscopic retrograde cholangiopancreatography

MeSH Terms

Cholangiopancreatography, Endoscopic Retrograde
Consensus
Electronic Health Records
Humans
Laparotomy
Pancreas
Pancreatic Ducts
Pancreatic Pseudocyst
Retrospective Studies