The role of diagnostic and therapeutic endoscopic retrograde pancreatography in traumatic pancreatic injury: a retrospective single-center study.

PURPOSE: Traumatic pancreatic injuries are uncommon but challenging to manage. This study aimed to clarify the clinical characteristics of traumatic pancreatic injury and explore the role of early endoscopic retrograde pancreatography (ERP) as a diagnostic and therapeutic approach. METHODS: We reviewed 14 patients with traumatic pancreatic injuries treated between 2007 and 2025. Injuries were classified according to the Japanese Association for the Surgery of the Trauma System. Clinical outcomes were analyzed according to early ERP use (≤ 24 h after injury). RESULTS: Three patients had a type I injury, one had a type II injury, five had a type IIIa injury, and five had a type IIIb injury. Patients with a type IIIa/b injury had higher serum amylase levels at 24 and 48 h, as well as higher secondary intervention rates and longer hospital stays. Among five patients who underwent early ERP, the main pancreatic duct injury was successfully bridged in one patient with a type IIIb injury, enabling non-operative management. There were no significant differences in clinical outcomes between the early ERP and delayed/no ERP groups. CONCLUSIONS: Appropriate management of traumatic pancreatic injuries resulted in favorable outcomes. Further studies are required to clarify the clinical importance of early ERP.