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2003, Number 4

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Cir Gen 2003; 25 (4)

Surgical behavior and treatment of pancreatic lesions (Part I)

Asensio JA, García JC, Petrone P, Roldán G, Pardo M, García WM, Karsidag T, Pak-art R, Kuncir E

Language: Spanish
References: 62
Page: 349-358
PDF size: 120.33 Kb.


ABSTRACT

Objective: To review some important aspects on the behavior and surgical treatment of lesions of the pancreas.
Data collection: Most of the available literature on the subject was reviewed (62 references).
Selection of the studies: Each article was critically analyzed, obtaining information on the history, anatomy, frequency, lesion mechanisms, associated lesions, and anatomic site of the lesions.
Results: Exploratory laparotomy was used for the first time in 1836, but the first abdominal exploration was performed during the I World War in 1914. The oldest recorded case of a pancreatic lesion was described in 1827, in London, England; in 1868, the first resection of a protruded segment of the pancreas was performed in Germany. In 1887, Senn published a monograph “Surgery of the pancreas”, stating “the absolute need of the surgical treatment of the penetrating lesions of the pancreas” The two large World Wars, and those of lower intensity (Corea and Vietnam) gave rise to the development of trauma surgery, and with it to surgery of the pancreas. The frequency of pancreatic lesions in armed conflicts is of 0.2% (I World War) to 2.3% (Korean War); in civilians, it ranges from 0.2 to 6%. Regarding associated lesions, the liver is the most affected, with a 19% frequency, and the most frequent locations are the head and the neck of the pancreas with 37%. Mortality due to traumatic pancreatic lesions can reach 23%.
Conclusion: The pancreas, due to its location, anatomic constitution, and poor symptomatic expression, is poorly affected, but highly lethal when lesioned.


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