胰腺及胰腺周围侵及血管的肿瘤手术难点对策与分析  

Surgery for pancreatic and peripancreatic tumors invading blood vessels:problems and management

作　　者：罗地来[1] 杨成义[1] 章永恩[1] 朱栋良[1] 罗刚[1] 

机构地区：[1]南昌大学第二附属医院肝胆外科,江西省南昌市330006

出　　处：《世界华人消化杂志》2009年第28期2919-2921,共3页World Chinese Journal of Digestology

摘　　要：由于胰腺位置深在,部位特殊,胰腺及胰腺周围侵及血管的肿瘤手术难度大,极易导致大出血,危及患者生命.作者结合自己的经验,总结了胰头癌侵及门静脉及肠系膜上静脉、胰体癌侵及脾静脉及脾动脉、胰头周围腹膜后恶性肿瘤累及肝下下腔静脉及左肾静脉的手术难点对策与分析,使用彭氏多功能手术解剖器(Peng'smultiple operative dissector,PMOD),细心操作,动作轻柔,熟悉肿瘤区域解剖,熟练掌握血管吻合技术,对高难度侵袭血管的肿瘤采用手术切除的方法,提高了手术切除率.努力探索解决这些临床问题的方法是进一步提高胰腺及胰腺周围恶性肿瘤治疗效果的关键.Due to the anatomic location of the pancreas,the surgery for pancreatic and peripancreatic tumors invading blood vessels is very diffi cult,often leading to massive hemorrhage and even endangering the patient s life.In this article,we will summarize our clinical experience on the management of problems arising from the surgery for pancreatic head carcinoma invading the portal vein and superior mesenteric vein,pancreatic body carcinoma involving the splenic vein and splenic artery,and peripancreatic retroperitoneal malignant tumors involving the inferior vena cava and left renal vein. Use of Peng＇s multi-functional operative dissector （PMOD）, careful and gentle operation, being familiar with the anatomy of the tumor region, better anastomotic skill and surgical resection of tumors involving blood vessels can help increase the success rate of the surgery and improve the therapeutic effect against pancreatic and peripancreatic tumors invading blood vessels.

关 键 词：胰腺肿瘤 血管 对策 方法 

分 类 号：R735.9[医药卫生—肿瘤]