胆胰肠结合部医源性损伤的术中发现与处理

Intraoperative diagnosis and treatment of iatrogenic injury in choledocho-pancreatico-duodenal junction

胆胰肠结合部是指胆管、胰管和十二指肠的汇合部位。因其特殊的解剖和病理生理等特点,医源性的胆胰肠结合部损伤最为常见。由于肝胆结石发病率的增高、胆道和胰腺手术的普遍开展以及内镜十二指肠乳头切开(EST)、内镜逆行胰胆管造影(ERCP)和胆道镜等新技术的推广,医源性胆胰肠结合部损伤常有发生。胆胰肠结合部损伤,往往术中难以及时发现,而出现严重的并发症,甚至死亡。因此,及时的术中发现与处理,对于病人的康复和预后都有着决定性的作用。

Choledocho-pancreatico-duodenal junction is the junction region of bile duct, pancreatic duct and duodenum. The iatrogenic injury in choledocho-pancreatico-duodenal junction is the most common complication due to its special anatomy and pathophysiology characteristics. As the higher morbidity of hepatolithiasis, more adoption of HBP surgeries and the popularization of new technologies such as EST, ERCP and choledochoscopy, iatrogenic injury in choledocho-pancreatico-duodenal junction becomes more common. Injury in choledoeho-panereatico-duodenal junction is usually hard to be diagnosed during the operation, which could result in serious complications, even death. So, timely diagnosis and treatment play a significant role in the recovery and prognosis of patients.