A case report of subtotal stomach preserving pancreaticoduodenectomy for treatment of type iiib pancreatic head injury involving the intrapancreatic common bile duct

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  • 亜全胃温存膵頭十二指腸切除術を施行した膵内胆管損傷合併IIIb型膵頭部損傷の1例

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Abstract

A 22-year-old woman was transferred to our hospital after being involved in a traffic accident. Physical examination revealed diffuse abdominal tenderness without peritoneal irritation. Abdominal computed tomography (CT) showed pancreatic head injury, liver injury and intra-abdominal bleeding. Conservative therapy was instituted. Abdominal CT of the next day revealed retroperitoneal fluid collection around the right kidney and increased ascites. Emergency surgery was performed 38 hours after the accident. During surgery, we discovered retroperitoneal biliary fluid collection and transection of the pancreatic head involving the pancreatic duct and the intrapancreatic common bile duct. We also discovered a parenchymal laceration 4 cm in depth in the lateral segment of the liver and contusion of the descending portion of the duodenum. Her general condition was stable. We performed a subtotal stomach preserving pancreaticoduodenectomy. Postoperatively, there was no pancreatic fistula. She was discharged on the 46th postoperative day.

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