Winter J, Ulatowski L, Hoffmann E
Chirurg. 1982 Sep;53(9):574-80.
Based on the experiences of our own with two papillary disconnections during partial gastric resection and 105 reports of the world literature (1916-1980), the cause, diagnosis and management of the injury is described. The most important factor favouring the operative accident is the foreshortening of the duodenum caused by the scarring of a chronic postbulbar ulcer. The ampulla of Vater may, therefore, be brought closer to the pylorus. The prognosis of the injury is not determined by the time of discovery, but it depends on the complete diagnosis of both severed ducts and adequate treatment. On delayed recognition the lesion may masquerade leaking of the duodenal stump. Successful repair can be achieved by reimplantation or invagination of the transsected common bile and pancreatic duct into the duodenal stump or an isolated Roux-en-Y-loop.
根据我们自己在部分胃切除术中两次乳头断离的经验以及世界文献（1916 - 1980年）中的105篇报道，描述了该损伤的病因、诊断和处理方法。导致手术意外的最重要因素是球后慢性溃疡瘢痕形成引起的十二指肠缩短。因此， Vater壶腹可能会更靠近幽门。损伤的预后并非取决于发现的时间，而是取决于对两根离断导管的完整诊断以及适当的治疗。如果延迟识别，该病变可能会伪装成十二指肠残端漏。通过将横断的胆总管和胰管重新植入或内翻至十二指肠残端或孤立的Roux - en - Y袢中，可以实现成功修复。
