联合门静脉／肠系膜上静脉切除的胰十二指肠切除术  

Portal/superior mesenteric vein resection in duodenopancreatectomy

作　　者：杨坤兴[1] 时开网[1] 席鹏程[1] 倪绍忠[1] 

机构地区：[1]南京医科大学附属南京第一医院普外科,210006

出　　处：《中国医师进修杂志（外科版）》2007年第2期5-6,10,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的 提高侵犯门静脉（PV）／肠系膜上静脉（SMV）的胰头癌的根治性切除率。方法 对11例胰头癌患者施行包括受侵PV／SMV在内的根治性整块切除术。结果 11例患者中3例行血管段切除、人造血管移植术，2例行血管段切除、血管端端吻合术，6例行血管壁楔形切除后修复术。术后并发切口裂开1例，顽固性腹水1例，肝功能损害加重1例，无胆胰漏、出血并发症。临床治愈10例，死亡1例。结论 对单纯侵犯PV／SMV的胰头癌行根治性整块切除术不仅可以完整切除病灶，达到根治性治疗的目的，而且术后并发症发生率及手术病死率并未明显增高，是安全、可行的术式。Objective To improve the resection rate of pancreatic head cancer invading portal vein （PV）/superior mesenteric vein （SMV）. Method Eleven cases of pancreatic head cancer underwent en bloc resection of invaded PV/SMV were reviewed retrospectively. Results In total 11 cases, 3 received segment resection of the PV/SMV and artificial vascular graft, 2 received segment resection and end to end anastomosis, 6 were performed lateral wall partial resection and reconstruction. Postoperative complications included disruption of wound in 1 case, obstinate ascites in 1 case, and aggravation of liver impairment in 1 case. There was no complication of pancreatic leakage or hemorrhage. Ten cases were cured and 1 case died. Conclusions Duodenopancreatectomy with PV/SMV resection not only can resect the tumor wholly, but also decrease the morbidity and mortality, which is a safe and feasible method to treat malignant tumor invaded PV/SMV of pancreatic head cancer.

关 键 词：胰腺肿瘤 胰十二指肠切除术 门静脉 肠系膜上静脉 

分 类 号：R735.9[医药卫生—肿瘤]