Early pancreatic dysfunction after resection in trauma: An 18-year report from a Level I trauma center.

Background: Early pancreatic dysfunction after resection in trauma has not been well characterized. The objective of this study was to examine the incidence and clinical impact of new-onset endocrine and exocrine dysfunction following pancreatic resection for trauma. Methods: All patients sustaining a pancreatic injury from 1996 to 2013 were identified. Patients with pre-injury diabetes were excluded. Survivors were divided into three groups according to the extent of anatomic resection - distal, proximal or total pancreatectomy. Clinical demographics and outcome data were abstracted. Blood glucose levels, hemoglobin A1c and insulin requirements were used to assess endocrine pancreatic function. Reported steatorrhea, diarrhea or supplemental pancreatic enzyme requirements were used to assess exocrine pancreatic function. Results: During the study period, 331 pancreatic injuries were identified, of which 109 (33%) required resection and 84 survived to hospital discharge. Four were excluded. Of 80 cases analyzed, 73 (91%) underwent distal pancreatectomy, 7 (9%) proximal pancreatectomy and none a total pancreatectomy. The distal resection group was predominantly male (88%), median age 24 years, and mean BMI 27 (kg/m2). Thirty-eight (52%) required insulin postoperatively, with the greatest proportion (47%) requiring insulin for

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