Introduction: Emergency pancreaticoduodenectomy (UPDD) is a surgery reserved for severe pan-creaticoduodenal injuries secondary to trauma, inflammatory injuries or after endoscopic procedures. Aim: To describe two clinical cases in which PDDU was performed. Clinical Cases: 2 clinical cases are reported in which a PDDU was required. The first case was secondary to a perforated duodenal ulcer that compromised more than 50% of the lumen associated with biliperitoneum uncontrolled duodenal fistula; in the second one, as a consequence of a gunshot wound trauma with duodenal perforation, distal ileum and a 1.5 cm tear in the head of pancreas. Discussion: Currently there is no consensus on the indications for UPDD, however this complex surgery represents a treatment option in well-selected patients, when damage control surgery and attempts to control necrosis and duodenal fistulas have failed. Conclusion: Treatment of a complex pancreatic and duodenal injury may require pancreatoduodenectomy. However, in unstable patients, a two-stage surgery should be considered by an experienced surgical team.