胆胰汇合部医源性损伤的预防及处理原则

Prevention and treatment strategy of iatrogenic injury in choledocho-pancreatico-duodenal junction

胆胰汇合部是指胆管、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,医源性胆胰汇合部损伤最为常见。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、内镜逆行胰胆管造影和胆道镜等新技术的推广,医源性胆胰汇合部损伤常有发生。胆胰汇合部损伤较为隐蔽,损伤后易发生延误诊断,并发症较为严重,病死率极高。因此需要深入认识胆胰汇合部医源性损伤的发生原因和诊疗策略。胆胰汇合部损伤的早期诊断、合理治疗以及有效预防,可显著降低胆胰汇合部医源性损伤的病死率。

Choledocho-pancreatico-duodenal junction（CPDJ）is the junction region of bile duct,pancreatic duct and duodenum.The iatrogenic injury in CPDJ is the most common complication due to its special anatomy and pathophysiology characteristics.As the higher morbidity of hepatolithiasis,more adoption of hepato-pancreato-biliary（HBP）surgeries and the popularization of new technologies such as EST,ERCP and choledochoscopy,iatrogenic injury in CPDJ becomes more common.Injury in CPDJ is usually hard to be diagnosed,which can result in serious complications,high morbidity and mortality.Therefore it requires further research in pathogenesis,diagnosis and management of iatrogenic injury of CPDJ.Morbidity and mortality of iatrogenic injury of CPDJ can be reduced significantly by the effective prevention,early diagnosis and proper management.