Introduction.

Treatment of severe pancreatic injuries is usually surgical resection; however, preserving the organ should be a priority. The objective of this study was to propose an alternative primary suturing approach to pancreatic transfixant injuries and to describe the early outcomes of patients treated at a level 1 Trauma Center.

Methods.

Descriptive study of patients with pancreatic trauma surgically treated at our institution between 2012 and 2022. Clinical characteristics, severity according to the AAST classification, clinical outcomes, and mortality were analyzed.

Results.

107 patients were included, 84% men, with median age of 25 years (IQR 19-32) and ISS of 25 (IQR 13-41). 82% (n=89) had penetrating trauma. Pancreatic lesions were grade I in 32 (30%) patients, grade II in 43 (40%), grade III in 28 (26%), grade IV in 3 (3%), and grade V in 1 (1%). Primary suturing was performed in 44 (41%) patients and pancreatectomy in 15 (14%). The incidence of of postoperative fistula among patients treated with suture was 33.3% (n=4) and 43% (n=6) with pancreatectomy. One pancreatectomy patient presented with diabetes at discharge (1%). In-hospital mortality rate was 10.2% (n=11).

Conclusion.

Management of pancreatic trauma with primary suturing is a viable and safe option. In our cohort, the organ was preserved in almost half of the patients with severe injuries, without increasing the rate of fistulas.

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