Diagnosis and management of iatrogenic choledocho-pancre-atico-duodenal junction injury / 中华消化外科杂志

ABSTRACT

The anatomy and position of choledocho-pancreatico-duodenal junction are unique,so choledocho-pancreatico-duodenal junction is easily be injured during operation,and thus it needs further investigation.Anatomical,pathological and iatrogenic factors are the 3 main causes of choledocho-pancreatico-duodenal junction injury.The diagnosis of choledocho-pancreatico-duodenal junction injury includes intraoperative and postoperative diagnosis; and the treatment methods include intraoperative repaire and suture,T tube drainage,postoperative debridement and drainage,biliopancreatic shunt,duodenal diverticulum,jejunum stoma,gastrointestinal and biliary reconstruction.Precise operation,T tube cholangiography,choledochoscopy can effectively prevent the choledocho-pancreatico-duodenal junction injury.The principle of early discovery,early management,avoiding over-management,and promoting damage control surgery should be awared to reduce the mortality.