联合门静脉和/或肠系膜上静脉切除的扩大胰十二指肠切除术
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李斌生

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Extended pancreaticoduodenectomy combined with resection of the involved portal vein(PV) and superior mesenteric vein(SMV)
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    摘要:

    目的 :探讨胰头癌侵犯门静脉和/或 肠系膜上静脉(PV/SMV)时的根治切除的可行性。方法 :回顾分折包括受侵PV/SMV 在内的扩大胰头十二指肠切除术16例的临床资料。16例均行胰头十二指肠切除术,其中9例行血管壁部分切除,5例行血管节段性切除及对端吻合,2例行受侵血管切除+自体静脉移植。结果 :全组患者术后均未发生血管栓塞、肠坏死、肝衰竭等并发症。除l例并发多器官衰竭于术后2d死亡外,均康复出院。15例均随访。存活超过3年者3例,超过5年者1例,存活3~26个月4例。结论 :对单纯侵犯PV/SMV的胰头癌施行联合PV/SMV在内的胰头癌扩大根治术是可行的。

    Abstract:

    Abstract:Objective :To explore the feasibilityof the radical resectionof cancer of head of pancreas with involving PV and SMV.
    Methods :The data of 16 cases who underwent extended pancreaticoduodenectomy for tumors with involvement of PV/SMV were analysed retrospectively. The 16 cases all underwent extended pancreaticoduodenectomy. In 9 of the 16 cases partial resection of the wall of blood vessels was performed,5 cases mnderwent segmental resection of the blood vessel and end-end anastomosis,2 cases had segmental resection of the blood vessel and homologous vein transplantation.
    Results :No cases of embolization,intestinal necrosis or hepatic failure were found in the whole group. One case died of mutiple organ failure was days after operation,and all the others were survival after operation and were followed up.Survival time was more than 3 years in 3 cases, and more than 5 years in 1 case,and 3~26 minths in 4 cases.
    Conclusions :It is feasible to perform extended pancreaticoduodenectomy for cases of pancreatic head carcinoma with involvement of PV/SMV.

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李斌生,钟德玝,苗雄鹰,周钧.联合门静脉和/或肠系膜上静脉切除的扩大胰十二指肠切除术[J].中国普通外科杂志,2006,15(11):1-803.
DOI:10.7659/j. issn.1005-6947.2006.11.001

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  • 在线发布日期: 2006-11-25