Successful combination strategy of preoperative placement of an endoscopic nasopancreatic drainage catheter and pancreas preservation surgery for pancreatic injury with major pancreatic duct disruption: a case report
Abstract Background The guidelines recommend pancreatic resection for grade III and IV pancreatic injuries. On the other hand, organ preservation is an important issue. Herein, we present the first case of pancreatic injury with major pancreatic duct (MPD) disruption that was treated with the combin...
Main Authors: | , , |
---|---|
Format: | Article |
Language: | English |
Published: |
SpringerOpen
2019-11-01
|
Series: | Surgical Case Reports |
Subjects: | |
Online Access: | http://link.springer.com/article/10.1186/s40792-019-0743-1 |
id |
doaj-2a3b917f097243e9965bfd77e76da797 |
---|---|
record_format |
Article |
spelling |
doaj-2a3b917f097243e9965bfd77e76da7972020-11-25T04:11:34ZengSpringerOpenSurgical Case Reports2198-77932019-11-01511610.1186/s40792-019-0743-1Successful combination strategy of preoperative placement of an endoscopic nasopancreatic drainage catheter and pancreas preservation surgery for pancreatic injury with major pancreatic duct disruption: a case reportKenji Kandori0Wataru Ishii1Ryoji Iizuka2Department of Emergency and Critical Care Medicine, Japanese Red Cross Society Kyoto Daini HospitalDepartment of Emergency and Critical Care Medicine, Japanese Red Cross Society Kyoto Daini HospitalDepartment of Emergency and Critical Care Medicine, Japanese Red Cross Society Kyoto Daini HospitalAbstract Background The guidelines recommend pancreatic resection for grade III and IV pancreatic injuries. On the other hand, organ preservation is an important issue. Herein, we present the first case of pancreatic injury with major pancreatic duct (MPD) disruption that was treated with the combination of preoperative placement of endoscopic nasopancreatic drainage (ENPD) catheter and pancreas preservation surgery after endoscopic pancreatic stenting (EPS) failure. Case presentation A 70-year-old female diagnosed with pancreatic injury was admitted to our hospital. She was hemodynamically stable. ERP revealed MPD disruption, and EPS failed. An ENPD catheter was placed preoperatively at the site of injury. During laparotomy, we identified a partial-thickness laceration in the pancreatic body. At the site of injury, the tip of the ENPD catheter was found; therefore, the patient was diagnosed with grade III pancreatic body injury with MPD disruption. The extent of crush was not severe, and we had no difficulty in identifying the distal MPD segment. We inserted the ENPD catheter into the distal MPD segment. The ruptured MPD and the laceration was sutured, then pancreatic resection was prevented. She was discharged on POD 56. Conclusion The treatment strategy incorporated ERP, placement of an ENPD catheter preoperatively, and a simple surgery in a hemodynamically stable patient with pancreatic injury allows the pancreas and spleen to be preserved.http://link.springer.com/article/10.1186/s40792-019-0743-1Endoscopic nasopancreatic drainage (ENPD)Endoscopic retrograde pancreatography (ERP)Major pancreatic duct (MPD)Pancreatic injuryPancreas preservationTrauma |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Kenji Kandori Wataru Ishii Ryoji Iizuka |
spellingShingle |
Kenji Kandori Wataru Ishii Ryoji Iizuka Successful combination strategy of preoperative placement of an endoscopic nasopancreatic drainage catheter and pancreas preservation surgery for pancreatic injury with major pancreatic duct disruption: a case report Surgical Case Reports Endoscopic nasopancreatic drainage (ENPD) Endoscopic retrograde pancreatography (ERP) Major pancreatic duct (MPD) Pancreatic injury Pancreas preservation Trauma |
author_facet |
Kenji Kandori Wataru Ishii Ryoji Iizuka |
author_sort |
Kenji Kandori |
title |
Successful combination strategy of preoperative placement of an endoscopic nasopancreatic drainage catheter and pancreas preservation surgery for pancreatic injury with major pancreatic duct disruption: a case report |
title_short |
Successful combination strategy of preoperative placement of an endoscopic nasopancreatic drainage catheter and pancreas preservation surgery for pancreatic injury with major pancreatic duct disruption: a case report |
title_full |
Successful combination strategy of preoperative placement of an endoscopic nasopancreatic drainage catheter and pancreas preservation surgery for pancreatic injury with major pancreatic duct disruption: a case report |
title_fullStr |
Successful combination strategy of preoperative placement of an endoscopic nasopancreatic drainage catheter and pancreas preservation surgery for pancreatic injury with major pancreatic duct disruption: a case report |
title_full_unstemmed |
Successful combination strategy of preoperative placement of an endoscopic nasopancreatic drainage catheter and pancreas preservation surgery for pancreatic injury with major pancreatic duct disruption: a case report |
title_sort |
successful combination strategy of preoperative placement of an endoscopic nasopancreatic drainage catheter and pancreas preservation surgery for pancreatic injury with major pancreatic duct disruption: a case report |
publisher |
SpringerOpen |
series |
Surgical Case Reports |
issn |
2198-7793 |
publishDate |
2019-11-01 |
description |
Abstract Background The guidelines recommend pancreatic resection for grade III and IV pancreatic injuries. On the other hand, organ preservation is an important issue. Herein, we present the first case of pancreatic injury with major pancreatic duct (MPD) disruption that was treated with the combination of preoperative placement of endoscopic nasopancreatic drainage (ENPD) catheter and pancreas preservation surgery after endoscopic pancreatic stenting (EPS) failure. Case presentation A 70-year-old female diagnosed with pancreatic injury was admitted to our hospital. She was hemodynamically stable. ERP revealed MPD disruption, and EPS failed. An ENPD catheter was placed preoperatively at the site of injury. During laparotomy, we identified a partial-thickness laceration in the pancreatic body. At the site of injury, the tip of the ENPD catheter was found; therefore, the patient was diagnosed with grade III pancreatic body injury with MPD disruption. The extent of crush was not severe, and we had no difficulty in identifying the distal MPD segment. We inserted the ENPD catheter into the distal MPD segment. The ruptured MPD and the laceration was sutured, then pancreatic resection was prevented. She was discharged on POD 56. Conclusion The treatment strategy incorporated ERP, placement of an ENPD catheter preoperatively, and a simple surgery in a hemodynamically stable patient with pancreatic injury allows the pancreas and spleen to be preserved. |
topic |
Endoscopic nasopancreatic drainage (ENPD) Endoscopic retrograde pancreatography (ERP) Major pancreatic duct (MPD) Pancreatic injury Pancreas preservation Trauma |
url |
http://link.springer.com/article/10.1186/s40792-019-0743-1 |
work_keys_str_mv |
AT kenjikandori successfulcombinationstrategyofpreoperativeplacementofanendoscopicnasopancreaticdrainagecatheterandpancreaspreservationsurgeryforpancreaticinjurywithmajorpancreaticductdisruptionacasereport AT wataruishii successfulcombinationstrategyofpreoperativeplacementofanendoscopicnasopancreaticdrainagecatheterandpancreaspreservationsurgeryforpancreaticinjurywithmajorpancreaticductdisruptionacasereport AT ryojiiizuka successfulcombinationstrategyofpreoperativeplacementofanendoscopicnasopancreaticdrainagecatheterandpancreaspreservationsurgeryforpancreaticinjurywithmajorpancreaticductdisruptionacasereport |
_version_ |
1724417141753511936 |