Diagnosis and treatment of injury in choledocho-pancreatico-duodenal junction
10.3760/cma.j.issn.1673-9752.2009.03.008
- VernacularTitle:胆胰肠结合部损伤的诊断和治疗
- Author:
Junmin WEI
;
Hongyuan CUI
;
Qing HE
- Publication Type:Journal Article
- Keywords:
Choledocho-pancreatico-duodenal junction;
Injury;
Diagnosis;
Treatment
- From:
Chinese Journal of Digestive Surgery
2009;8(3):181-183
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the diagnosis and treatment of injury in choledocho-pancreatico-duodenal junction. Methods The clinical data of 6 patients with injury in choledocho-pancreatico-duodenal junction who had been admitted to Beijing Hospital from January 2000 to January 2008 were retrospectively analyzed. Results Of the 6 patients, 4 were diagnosed according to the intraoperative findings, cholangiography and fiber cholangioscopy. The 4 patients were cured after suture of the perforation in the choledocho-pancreatico-duodenal junction, T-tube drainage and abdominal drainage. Two patients developed severe abdominal and retroperitoneal infection and other complications after operation, and were diagnosed by cholangiography and fiber cholangioscopy. Of the 2 patients, 1 was cured and 1 died after multiple drainage procedures and debridement. Conclusions Diagnosis and treatment in the early stage are crucial for the curative purpose. Cholangingraphy and fiber cholangioscopy are effective in the diagnosis of injury in choledocho-pancreatico-duodenal junction. The suture of the perforation in the choledocho-pancreatico-duodenal junction, T-tube drainage and abdominal drainage should be chosen for patients who are diagnosed during primary operation. For patients with abdominal and retroperitoneal abscess and cellulitis, drainage and debridement should be performed, and biliopancreatic diversion and duodenal diverticularizatian are applied to patients when necessary.
