Treatment for severe injury in conjoint part of common bile duct, duodenum and pancreas by vacuum sealing drainage
HUO Jing-shan
CHEN Wu-ming
WU Ri-zhao
WU Min-han
ZHUANG Zhi-hao
LU Yan-chuan
TAO Shi-ming
Abstract：Objective To observe the efficacy of treatment for severe injury in conjoint part of common bile duct,duodenum and pancreas by vacuum sealing drainage (VSD).Methods The clinical data of 10 patients with severe injury in conjoint part of common bile duct ,duodenum and pancreas admitted during Jan .1998 and Nov.2015 was retrospectively analyzed.Among them 8 were males and 2 were females with an average of (29 ±10.39)(16-45) years.All were closed injures.Three were injured from traffic accidents,3 from crush injury,2 from motorcy-cles accidents and 2 from high falling .All patients were performed the emergency operation .The pancreatic lacera-ted wounds were given debridement and blood-control and duodenal lacerated wound was sutured monolayer , then VSD was performed in the location of pancreatic and duodenal injury . Results Operative time was 60-280 min (average 175min).There was no one died,and 1 patient was transferred to another hospital because of abdominal bleeding after operation ,9 cases were cured.The patients'hospital stay was from 27 to 43 days.There were 5 cases with postoperative digestive fluid leakage ,which included 2 cases of pancreatic leakage ,one case of duodenal leak-age,one case of pancreatic and duodenal leakage ,and one case of biliary,pancreatic and duodenal leakage .All the complications were treated by VSD ,the former three cases were cured nonoperatively .Pancreatic and duodenal leak-age was drained from the tube of VSD in the other two patients .Approximately 16 and 23 days after the first opera-tion when the integrated fistula tract around the tube of VSD was formed ,the Roux-en-Y anastomosis between jeju-num and the fistula tract was carried out in the two cases .Patients were followed up from 6 months to 17 years;there were no intra-abdominal infections , abdominal effusion , pancreatic pseudocyst , obstruction or other complications . Conclusion The treatment for severe injury in conjoint part of common bile duct ,duodenum and pancreas by VSD has good curative effects .If the patients have very dangerous conditions ,they can be treated by simple debridement combined with biliary ,pancreatic and duodenal trauma plus VSD .
Keywords：bile duct and pancreatic injuryconjoint partpancreatic leakagebiliary leakageintestinal leakagevacuum sealing drainage
Publication Date：2017-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 17-21 )