摘要
目的探讨"动脉优先"入路在胰头癌行胰十二指肠切除术中的应用范围和技巧。方法先探查肠系膜上动脉(SMA)判断可切除性后,完成以SMA、腹腔干为轴的右侧神经、淋巴组织的完全切除。结果 6例患者中,2例从右侧入路、3例从左后方入路、1例从前方入路完成SMA探查,其中2例行内引流术,另4例完成保留幽门胰十二指肠切除术(PPPD)。术后除2例患者胃排空障碍外,无出血、胰瘘、腹泻等并发症。结论 "动脉优先"入路具有上述理论优势,同时不增加并发症发生率,但其在切缘、预后方面的优势则还需进一步临床验证。
Objective To investigate the application of ＂artery first＂ approach in resection of pancreatic head cancer,and to summarize the experience with this operative technique.Methods We performed an ＂artery first＂ approach for 6 patients with pancreatic head cancer,which requires a dissection of the SMA.If it was resectable,radical resection was performed for the nervous and lymphatic tissue around the axis of the celiac artery and SMA.Results Right,left posterior,and anterior approaches were performed in 2,3 and 1 patients,respectively.Among them,2 patients underwent palliative hepatojejunostomy,and 4 received pylorus preserving pancreaticoduodenectomy（PPPD）.Except for 2 patients with delayed gastric emptying,no major complication occured.Conclusions ＂Artery first＂ approach has the theoretical advantage without increase of complications.However,its advantages still need further clinical validation.
出处
《中华普外科手术学杂志（电子版）》
2011年第2期29-32,共4页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
关键词
胰十二指肠切除术
肠系膜上动脉
后腹膜切缘
Pancreaticoduodenectomy
Mesenteric artery
superior
Retroperitoneal margin
