As for the treatment for injuries of the main pancreatic duct, removal or reconstruction of the pancreas is reliable; however, the treatment method for pancreatic injuries (type IIIb) (JAST) has not been established yet. There were 14 cases of pancreatic injuries (type IIIb) in our hospital and relevant institutions encountered within 28 years, and emergency Endoscopic Retrograde Pancreatography (ERP) was performed 10 times (one of them being in surgery). As for the treatment method, pancreaticoduodenectomy was performed in 5 cases, distal pancreatectomy in 3, the Letton & Wilson approach in 3, and 1 case each for suturing the main pancreatic duct, drainage treatment and endoscopic stent treatment. Although one patient died at the beginning of surgery, the overall results were still satisfactory. When the surgical approach is considered, reliable evaluation of the main pancreatic duct is very important and ERP is very useful. According to the different symptoms, there will be some cases in which surgery can be avoided by using endoscopic stent placement. ERP will gradually become more important.