J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text PDF] （in Japanese / 1962KB） [Members Only And Two Factor Auth.]

J.Jpn. Surg. Soc.. 96(8): 569-576, 1995

Original article

THE ROLE OF EMERGENT ENDOSCOPIC RETROGRADE PANCREATOGRAPHY (ERP): ITS USEFULNESS IN THE DIAGNOSIS OF PANCREATIC INJURY

1) Department of Emergency and Critical Care Medicine, Kitasato University, School of Medicine, Sagamihara, Japan
2) Department of Surgery, Kitasato University, School of Medicine, Sagamihara, Japan

Tsunemasa Takishima1), Katsuhiko Sugimoto1), Tetsuaki Sakaguchi1), Yasushi Asari1), Takaaki Kikuno1), Akira Kakita2), Takashi Owada2)

To determine the therapeutic modalities for pancreatic injury (PI), it is important for the pancreatic ductal injury (DI) to be present or not. We performed ERPs in 36 patients who had positive findings in physical examinations, serum amylase levels and CT within about 13 hours after injury to diagnose the DIs early after injury and to avoid negative laparotomy.
In 33 successful ERP patients (intraoperatively in 3), 22 had PIs (14 Dls) and ll had non-Pls. Of 14 patients with DIs, 12 with main DIs and one with branch injury were treated surgically. Another patient with branch injury, who was treated conservatively, died of the complications of PI. Nineteen patients without DIs, including 8 PIs, were treated conservatively or operated for the associated abdominal injuries, who had no complications on PIs in the hospital days. Three unsuccessful ERP patients, having PIs, were also operated upon. Among 15 patients, including these 3 patients and 12 treated surgically during the era before introducing ERPs, 2 (13.3%) negative laparotomies were noted. Among 16 patients, who underwent both of ERP and operation, no negative laparotomies were noted. No complications of ERPs occurred.
In conclusion, ERP is a reliable modality to detect DIs and to determine the therapeutic modalities for PIs.

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