经肠系膜入路的胰十二指肠根治性切除术  

Radical pancreaticoduodenectomy via mesenteric approach

作　　者：崔云甫[1] 王志东[1] 钟翔宇[1] 康鹏程[1] 

机构地区：[1]哈尔滨医科大学附属第二医院胰胆外科,150086

出　　处：《中华消化外科杂志》2013年第8期608-611,共4页Chinese Journal of Digestive Surgery

基　　金：黑龙江省科技厅攻关项目（GC12C304-1）;黑龙江省留学回国人员科技项目择优资助项目（2011297）

摘　　要：胰十二指肠根治性切除术是可能治愈胰头癌和壶腹周围癌的惟一有效方法。早期明确肠系膜上动脉（SMA）是否受侵犯及其侵犯程度，对术中术式决策及判断患者的预后具有重要的指导意义。基于肿瘤的手术切除应遵循无瘤、足够的切除范围、安全的切缘、充分的淋巴结清扫等原则。采用肿瘤无接触、肿瘤整块切除及肿瘤供应血管优先处理等技术，笔者提出经肠系膜入路的根治性胰十二指肠切除术。2011年12月至2012年12月哈尔滨医科大学附属第二医院采用该术式为24例胰头和壶腹周围癌患者顺利施行了胰十二指肠根治性切除术，近期疗效满意。Radical pancreaticoduodenectomy is the only effeetive method for the treatment of malignancies in the pancreatic head and the periampulary region. Early determina- tion of the involvement of the superior mesenteric artery （SMA） is important for the selection of the surgical procedure and judg- ment of the prognosis. The operation should follow the principle of tumor-free and adequate resection range, safe resection margin and complete lymph node resection. For this purpose, we performed the radical pancreatieoduodenectomy via mesenterie approach. The SMA was dissected first, and then the tumor was en-bloc resected. From December 2011 to December 2012, 24 patients with tumors in the pancreatic head or the periampullary region received radical pancreaticoduodenectomy via the mesen- teric approach at the Second Affiliated Hospital of Harbin Medical University, and the short-term outcome was satisfactory.

关 键 词：胰头肿瘤 壶腹周围肿瘤 胰十二指肠 切除术 肠系膜入路 R0切除 

分 类 号：R735[医药卫生—肿瘤]