Pancreatic and Duodenal Injuries (Sleep When You Can…)

Abstract

I have a unique perspective here. I am a surgical oncologist who has the benefit of being exposed to the intense trauma surgery of war. I take trauma call in a level 2 trauma Center and I have been deployed to the busiest combat support hospital’s in Iraq as well as being deployed to a desolate forward surgical team in Afghanistan where the only help I had was the skills I possess. I remember saying to the editor of this book (and good friend), “Any surgical oncologist can be a trauma surgeon because we are comfortable operating anywhere in the body and we routinely operate on the pancreas and the liver.” Obviously, that was an incorrect statement because the trauma patient has a very distinct physiology requiring attention to much more than just the technique of how to do a complex surgery. This was a lesson that I learned the hard way. On the flip side, pancreatic and duodenal injuries can be very difficult to manage if you do not routinely operate in this area. For a surgeon who does not have experience in complex operations and those involving the pancreas and the duodenum, the midst of the acute trauma is not the time to try to learn.