Pancreatic and duodenal injuries (don't mess with the.)

The comfort in performing complex operations in different parts of the body does not prepare you for the chaos of combat casualty care, for the stark limitations imposed by the austerity of far-forward combat trauma care, and for the experience and judgment required to understand the optimal care of the traumatically injured wartime patient. Whether you are an experienced pancreas surgeon or an experienced surgeon with minimal exposure to pancreas surgery, pancreaticoduodenal trauma will humble you. The keys to success in managing these extraordinarily challenging and relatively rare injuries are to prepare well in advance by reading and reviewing techniques and scenarios; keep the management principles as simple, straightforward, and quick as possible; try to delay complex or time-consuming reconstructions; and get help early.