Management of left XXXX .

@entity1 @entity788 @entity1661 @entity660 @entity3472 @entity9007 @entity130
Left pancreatic @entity130 (LPTs) are rare but serious lesions occurring in 1 to 6 per cent of @entity1661 @entity1 and mainly resulting from blunt @entity130 . LPT severity is primarily dependent on the associated @entity130 and secondarily related to main @entity660 responsible for complications: acute @entity788 , @entity9007 , @entity3472 , or abscesses. The guidelines for blunt LPT management can be presented as follows. In case of emergency laparotomy, pancreas exploration is mandatory to detect @entity660 . In the absence of main @entity660 , simple drainage is advocated. In case of distal injury to the main pancreatic duct, a left pancreatectomy is mandatory. In the absence of initial laparotomy, the diagnosis is more and more based on CT and magnetic resonance cholangiopancreatography, which tend to replace endoscopic retrograde cholangiopancreatography (ERCP) as a first-intent diagnostic modality. In case of distal injury to the main pancreatic duct, spleen-preserving distal pancreatectomy is recommended. In the absence of main @entity660 , nonoperative treatment is advocated. When LPTs are discovered at the time of complications, @entity3472 and/or @entity9007 are associated with main @entity660 , which can be treated by pancreatic duct stenting at ERCP and/or internal endoscopic cystogastrostomy. However, in such cases, spleen-preserving distal pancreatectomy remains the treatment of choice. @entity660 resulting from LPT have to be diagnosed early to avoid late complications. Distal pancreatectomy remains the treatment of choice in case of severe @entity660 because the role of ERCP stenting and endoscopic techniques needs further evaluation.
