Abstract:

Several issues worthy of attention on standardized diagnosis and therapy of pancreaticoduodenal injury                 MIAO Yi, GAO Wen-tao. Pancreas Center，the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029,China
Corresponding author：MIAO Yi,E-mail：miaoyi@njmu.edu.cn
Abstract    The pathogenesis mechanism and management of pancreas and duodenal injury have both relationships and differences. Management of pancreatic injury is related to injury classification，in which pancreatic duct injury is the top priority. MRCP and ERCP can diagnose pancreatic duct injury with high accuracy，but it is controversial for ERCP as a treatment. Nonoperative management is suitable for patients free of duct injuries. If three is pancreatic duct injury，generally appropriate debridement，resection and reconstruction should be considered. Damage control surgery is an option for critically ill patients with giving appropriate initial treatment and delayed reconstructive operation. Decision-making of duodenal injury also rely on injury classification. The general principle is primary repair with adequate drainage.

Key words: pancreaticoduodenal injury, magnetic resonance cholangiopancreatography, endoscopic retrograde cholangiopancreatography

摘要：

胰腺及十二指肠损伤的发生机制及处理有关联也有差异。胰腺损伤的处理决策与其分级相关，其中胰管损伤是重要的决策和预后指标，磁共振胰胆管造影（MRCP）和内镜逆行胰胆管造影（ERCP）有助于胰管损伤的确切判断，但ERCP下胰管支架作为治疗手段存在争议；非手术治疗适用于无胰管损伤者，胰管损伤者通常须考虑行相应清创切除和重建；危重病人可遵循损伤控制原则，行相应初期处理，延期重建。十二指肠损伤的处理和损伤分级相关，共识是尽量一期修补和充分引流。

关键词: 胰十二指肠损伤, 磁共振胰胆管造影, 内镜逆行胰胆管造影