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胆胰肠结合部损伤延迟发现的处理
引用本文:王坚. 胆胰肠结合部损伤延迟发现的处理[J]. 中华消化外科杂志, 2009, 8(3). DOI: 10.3760/cma.j.issn.1673-9752.2009.03.007
作者姓名:王坚
作者单位:上海交通大学医学院附属仁济医院普通外科,200127
摘    要:

关 键 词:胆胰肠结合部  损伤  诊断  治疗

Management of delayed-diagnosed iatrogenic injury in cho-ledocho-pancreatico-duodenal junction
WANG Jian. Management of delayed-diagnosed iatrogenic injury in cho-ledocho-pancreatico-duodenal junction[J]. Chinese Journal of Digestive Surgery, 2009, 8(3). DOI: 10.3760/cma.j.issn.1673-9752.2009.03.007
Authors:WANG Jian
Abstract:Iatrogenic injury in choledocho-pancreatico-duodenal junction is usually difficult to discover in the course of operation because of its unique anatomical position. The injury can lead to postoperative chilis, fever, pain and swelling of the waist, which would easily be misdiagnosed as acute necrotizing pancreatitis. Controlling operations, such as bile and pancreatic juice separation, duodenal diverticularization, jejunal fistulation for enteral nutrition and abdominal drainage should be performed in dealing with the injury in choledocho-pancreatico-duodenal junction. Combined application of pyloric suture with absorbable thread and ligatian, gastric fistulation, ligation of the distal common bile duct and T-tube drainage is minimally invasive, and can fulfill a fully separation of bile and pancreatic juice and duodenal diverticularization. It will improve the possibility of secondary radical operation by ameliorating pyemia and general nutritional condition.
Keywords:Choledocho-pancreatico-duodenal junction  Injury  Diagnosis  Treatment
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