Diagnosis and management of iatrogenic choledocho pancreatico duodenal junction injury

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.