Primary anastomosis is safe and may lead to better outcomes than ostomy for patients with severe pancreatic injuries and colon resection.

• Surgical site infections were similar: 10% for anastomosis vs 17.5% for ostomy (p = 0.184).
• Unplanned return to OR rates also showed no significant difference: 8.3% vs 14.2% (p = 0.260).

Choosing primary anastomosis can reduce hospital stays—median length of stay was 21 days for anastomosis vs 31 days for ostomy (p = 0.005).

• ICU stays were also shorter for anastomosis: 10 days vs 14 days (p = 0.033).