[Progress in the prevention and treatment of choledocho-pancreatico-duodenal-junction injury caused by ERCP].

Endoscopic retrograde cholangiopancreatography (ERCP) plays an increasingly important role in the diagnosis and treatment of pancreaticobiliary diseases. However, ERCP-related complications, particularly injuries to the pancreaticobiliary junction, remain a major clinical concern. Owing to the complex anatomy of this region, the pancreaticobiliary junction represents a high-risk site for severe adverse events during ERCP. Based on recent research advances and clinical experience, this article systematically reviews the major types, risk factors, diagnostic methods, and prevention and management of ERCP-related pancreaticobiliary junction injuries, with particular emphasis on the two most serious complications: hemorrhage and perforation. The risk factors and management of early and delayed hemorrhage are summarized, highlighting endoscopic therapy as the primary treatment, supplemented by interventional radiology and surgical approaches when necessary. In addition, the key imaging features and graded treatment strategies for different types of perforation are discussed. The characteristics of long-term complications after ERCP and their association with endoscopic sphincterotomy are also reviewed. Strict adherence to the indications for ERCP, optimization of procedural techniques, and standardized evaluation and management based on a multidisciplinary team approach are essential for reducing the incidence of pancreaticobiliary junction injuries and improving patient outcomes.