The treatment of pancreatic injury should take different approaches depending on the injury, but aim to be simple and effective. The general principle should be followed: first deal with fatal hemorrhage, and deal with cavity organ injury to prevent contamination, and finally deal with the pancreas. Non-surgical treatment Non-surgical treatment should be considered only for grade I and II injuries that are limited to no main pancreatic duct injury and combined injuries. If incomplete rupture of the pancreatic duct is found during ERCP examination, stent drainage can be placed. Peptidase can inhibit pancreatic secretion and is a new drug for non-surgical treatment of pancreatic injury, which can reduce the occurrence of pancreatic leakage and pancreatic pseudocysts. If there is swelling of the pancreas and peri-pancreatic fluid, surgical drainage can be performed; if there is suspicion of main pancreatic duct injury, early exploration is recommended. Surgical treatment The principles of surgical treatment are: (1) control bleeding; (2) remove inactivated pancreatic tissue; (3) perform biliary decompression surgery for more serious pancreatic injuries; (4) properly treat combined injuries; (5) treat broken pancreatic ducts; (6) perform adequate and effective peripancreatic drainage. Type II pancreatic injury should be treated by removing the necrotic pancreatic tissue and hematoma, carefully checking whether there are broken blood vessels and pancreatic ducts below the hematoma, and if there is no obvious pancreatic duct injury, external drainage can be placed after tight hemostasis, generally without suture repair. If the pancreatic injury is found to be type I or II during laparoscopic exploration, pancreatic necrotic tissue and hematoma removal is feasible, and drainage is placed. For type III pancreatic injury, resection is feasible, and the decision to preserve the spleen is made on a case-by-case basis. The number of pancreatic islets should be taken into consideration when resecting to prevent postoperative pancreatic insufficiency. In the management of type IV pancreatic injury, for the right transection injury of the mesenteric vessels, the proximal end can be closed and the distal end and jejunum can undergo Roux-en-Y anastomosis to facilitate the preservation of pancreatic function, and if necessary, Oddi sphincterotomy can be added to enhance the drainage of pancreatic fluid. If there is enough pancreatic tissue proximal to the severed end for preservation, distal pancreatic resection can also be used. If the proximal pancreatic duct is suspected to have reflux obstruction, the distal and proximal ends can be anastomosed with the jejunum separately to prevent postoperative pancreatic leakage. Injuries involving the jugular abdomen should be treated according to type V injury, and combined with duodenal injury, duodenal agenesis or modified duodenal agenesis should be performed to avoid the passage of food through the duodenum and reduce the secretion of gastric and pancreatic juices to promote the healing of pancreatic and duodenal injuries. Type V pancreatic injury can be treated with duodenal open heart surgery, modified duodenal open heart surgery or pancreatic head duodenectomy according to the specific situation. Pancreatic head duodenectomy is a treatment for severe injury to the extensive pancreatic head combined with severe duodenal and biliary tract injury, which is highly traumatic and has a high surgical mortality rate, and the indications for surgery should be strictly controlled. Prevention and treatment of postoperative complications There are many postoperative complications of pancreatic injury with high incidence, including pancreatic leakage, peripancreatic abscess, pancreatitis, pancreatic pseudocyst, postoperative bleeding and so on. Once pancreatic leakage occurs, treatment includes adequate drainage, nutritional support, inhibition of pancreatic secretion, and control of infection. 80% of pancreatic leaks can heal on their own with conservative treatment, but if they do not heal for more than 2 months, most of them need to be treated with surgery again. The prevention of peripancreatic abscess is firstly to enhance effective drainage and drainage of necrotic tissues outside the body, secondly to reasonably apply effective antibiotics, and to operate when conservative treatment is not effective after the occurrence of peripancreatic abscess. Pancreatic pseudocysts mostly occur after non-surgical treatment of blunt injuries to the pancreas. Pseudocysts of the pancreas are first conservatively treated to observe whether they are absorbed or not, while larger ones are treated with internal drainage after the wall of the cyst has matured and thickened; however, those who increase sharply during conservative observation should be operated on urgently for external drainage. Even if traumatic pancreatitis occurs as a manifestation of hemorrhagic necrotizing pancreatitis, surgical treatment is generally not recommended because of the difficulty of surgery, trauma and high mortality.