Prevention and treatment of iatrogenic injuries in choledocho-pancreatico-duodenal junction in Oddi sphincteroplasty        LIANG Li-jian，CHEN Wei. Department of Hepatobiliary Surgery，the First Affiliated Hospital of Sun Yat-sen University，Guangzhou 510080，China  
Corresponding author: LIANG Li-jian, E-mail: lianglj@medmail.com.cn
Abstract    Operative sphincteroplasty remains a common surgical procedure in clinical practice. The narrow operating field often leads to iatrogenic injury. The causes of iatrogenic injury include various facto such as anatomic, pathologic and surgical factors. Complications mainly include penetrating injury of bile duct and pancreas, acute pancreatitis caused by pancreatic duct obstruction, duodenal leakage, gastrointestinal hemorrhage and so on. Severe injury can lead to multiple complications and might be life-threatening. For the prevention of iatrogenic injury, it should adopt a series of measures including dissociating the descending part of the duodenal fully, identifying the duodenal papilla correctly, avoiding violent exploration, choosing the appropriate suture, anastomosing bile duct and duodenal mucosa carefully, closing the duodenal incision securely. Once complication occurred, it should manage the most urgent situation, and then find out the location and causes of the disease followed by proper management according to the etiology.