关键词: 十二指肠损伤, 胆道手术, 营养支持

Abstract:

Characteristics and countermeasures of duodenal injury in the biliary tract surgery        LU Qian，ZHANG Lei-da，BIE Ping. Institute of Hepatobiliary Surgery, Southwest Hospital of the Third Military Medical University，Chongqing 400038，China
Corresponding author：BIE Ping，E-mail：bieping@medmail.com.cn
Abstract    Duodenal injury is inevitable in the biliary surgery due to the complicated antanomy, roughly surgical procedures，duodenum invasion caused by infection or tumor, etc. The injury of anterior wall of duodenum can be easily identified and handled，while the injury of posterior wall is more difficult to indendify and can cause serious retroperitoneal corrosion and infection. Precise imaging assessment before operation，carefully identification of the complex anatomy relationships，gentle surgical procedures are the key points to prevent duodenalinjury. Once the duodenal injury occurs，it should be handled carefully in a timely manner. Reliable suture，adequate decompression and drainage are the basical treatment principles. The postoperative delay detection of duodenal injury is more difficult to handle. Patients may benefit from gastrointestinal diversion，jejunum stoma，exclusion the damage duodenum，which are the key resources to achieve good prognosis.

Key words: duodenal injury, biliary tract surgery, nutritional support