Analysis Of High-Risk Factors Of Latrogenic Duodenal Injuries And Surgical Tactics Of Treatnent According To Injuries Scaling

Objective To sum up and discern the high risk factors of iatrogenic duodenl injuries and to evaluate the value of the treatment according to the new trauma scaling ,so as to to facilitate and guide clinical research.Methods 32 patients with iatrogenic duodenal trauma hospitalized and From Jan.1998 to 2008,in our hospital and 3 another hospitals were collected and retrospectively reviewed,the duodenum organ iatrogenic injury scale was classified and developed depending on the clinical finding and referring to the injury scale by the American Association for the Surgery of Trauma(A.A.S.T.)in 1990.Results The iatrogenic duodenal injuries result from various surgery and endoscopic procedures,most from a sequelae to pertinent biliary operation and(or) iatrogenic technical errors of instrumention.High risk factors responsible for the iatrogenic injuries include inflammatory conglutination,biliary systems anomalies or anatomic variations,duodenal Vater's papilla with neoplasma or diverticulum .surgeohs with less experience or over self-confidence or some procedures with vio1ence and specific correctable errors,and so on.According to the new grading scheme,the duodenal injuries of the 32 cases were classified as follows:grade I一1 cases,grade II一13 cases,grade III一14 cases,grade IV一4 cases,and grade V一1 cases.The patients were treated according to the scaling.Conclusions Knowledge about causal factors of such iatrogenic processes can play a crucial role in their prevention,corect diagnosis,and management.Having the iatrogenic duodenal scaling done well,appears to be an accurate and practical way to select an optimum and flexible treatment and improve the patients's prognosis.