Arvieux C, Létoublon C
Département de chirurgie digestive et de l'urgence, centre hospitalier universitaire A.-Michallon, BP 17, 38043 Grenoble cedex 09, France.
Ann Chir. 2005 Mar;130(3):190-8. doi: 10.1016/j.anchir.2005.02.002.
If an emergency laparotomy is necessary, a damage control laparotomy may be useful. If during the laparotomy the hemodynamic is stabilised, the severity is depending on the existence of a ductal injury and an associated duodenal lesion. Surgical indications and techniques are described in these different cases. If no laparotomy, the location and type of injury is assessed by CT scan, magnetic resonance cholangiopancreatography or ERCP. Injury of the pancreatic duct is the main part of prognosis and indications. The non operative treatment in case of ductal injury remains controversial.
如果有必要进行急诊剖腹手术,损伤控制剖腹术可能会有用。如果在剖腹手术期间血流动力学稳定,严重程度取决于是否存在导管损伤和相关的十二指肠病变。在这些不同情况下描述了手术指征和技术。如果不进行剖腹手术,则通过CT扫描、磁共振胰胆管造影或内镜逆行胰胆管造影(ERCP)来评估损伤的位置和类型。胰管损伤是预后和指征的主要部分。导管损伤时的非手术治疗仍存在争议。