Introduction: Emergency pancreatoduodenectomy is a procedure that is indicated for the management of severe pancreaticoduodenal trauma after damage control surgery.Objectives: To present our experience of pancreaticoduodenal trauma management with emergency pancreatoduodenectomy and damage control surgery.Materials and methods: Retrospectively recorded data of patients with severe pancreaticoduodenal trauma who underwent a pancreatoduodenectomy and damage control for trauma at a high-volume trauma center.Results: In a period of 6 years, four patients (three men and one woman, median age 17.5 years, range: 16-21 years) with severe pancreaticoduodenal trauma underwent a pancreatoduodenectomy and damage control procedure (gunshot n = 4), and in a second surgical procedure underwent gastrointestinal tract reconstruction.In total, 75% incidence of surgical site infection (SSI) was reported, 25% healthcare-associated pneumonia, and 50% postoperative pancreatic fistula (POPF).Intensive care unit (ICU) of 12.25 and hospital stay of 29.5 days mean and no mortality.Conclusion: An emergency pancreatoduodenectomy can be a lifesaving procedure in patients with non-reconstructable duodenopancreatic injuries.Damage control surgery in pancreaticoduodenal trauma is an alternative for management although with high risk of morbidity.