结肠肝曲癌侵犯门静脉行联合肠系膜上静脉-门静脉切除对端吻合重建手术  

Superior mesentericoportal vein resection end to end anastomosis without graft interposition in patients of colonic cancer involving portal vein undergoing combined pancreatoduodenectomy

作　　者：任辉[1] 刘晶晶[1] 张国锋[1] 房学东[1] 

机构地区：[1]吉林大学普通外科疾病诊疗中心、吉林大学第二医院普外医院结直肠外科,长春130041

出　　处：《中华普通外科杂志》2013年第5期364-367,共4页Chinese Journal of General Surgery

摘　　要：目的探讨结肠肝曲癌侵犯门静脉行右半结肠根治切除（right hemicolectomy，RH）联合肠系膜上静脉．门静脉切除的胰十二指肠切除术（pancreaticoduodenectomy，PD）血管端端吻合的可行性。方法总结2004-2011年吉林大学普通外科疾病诊疗中心、吉林大学第二医院普通外科行右半结肠根治切除术及胰十二指肠切除、联合肠系膜上-门静脉切除术后血管进行端端吻合5例患者的临床资料。结果5例患者手术过程均顺利，肿瘤完全切除，无严重术后并发症及围手术期死亡，5例患者均康复出院。结论结肠肝曲癌极易侵犯胰头十二指肠及（或）门静脉，行右半结肠癌根治切除术及胰十二指肠切除，联合肠系膜上-门静脉切除后均未间置人工血管进行端端吻合是一项安全可行的技术。Objective To evaluate the feasibility and safety of portal-superior mesenteric vein resection and end-to-end anastomosis in cases of colonic carcinoma invading portal vein undergoing combined fight hemicolectomy （ RH ） and panereatieoduodenectomy （ PD ） without the need of graft interposition. Methods From 2004 to 2011, 5 patients underwent resection of right-sided colon and pancreaticoduodeneetomy combined mesenterieoportal vein resection at a length from 3 to 4 cm and end-to- end anastmoses without graft. Results Surgery was successful in all 5 patients, with complete resection, no severe complications occurred, and all 5 patients were cured. Conclusions Cancers in hepatic flexure of the colon frequently infiltrates the head of the pancreas and duodenum, involving the portal vein. Conservative radical fight hemieoleetomy and panereaticoduodeneetomy combined long mesentericoportal vein resection and end-to-end anastmoses without graft is a reasonable and safe procedure.

关 键 词：结肠肿瘤 胰十二指肠切除术 门静脉 

分 类 号：R735[医药卫生—肿瘤]