Clinical course and pancreas parenchyma sparing surgical treatment of severe pancreatic trauma

•Severe pancreatic trauma represents a major challenge for interdisciplinary trauma teams and management remains highly individualized.•Determination of main pancreatic duct involvement is crucial for appropriate clinical decision-making; to this end, if possible, MRI or ERP should be performed next to standard trauma CT scans.•For grade III/IV pancreatic trauma with distal/proximal transection of the gland, parenchyma-preserving procedures appear safe and should be considered.