胰十二指肠切除术中血管损伤预防及处理  

Prevention and management for the vescular injury during pancreaticoduodenectomy

作　　者：庄岩[1] 高红桥[1] 杨尹默[1] 

机构地区：[1]北京大学第一医院外科,北京100034

出　　处：《中国实用外科杂志》2014年第12期1125-1127,共3页Chinese Journal of Practical Surgery

摘　　要：胰十二指肠切除术是消化道外科手术中的经典术式,具有一定的复杂性和挑战性。与术后胰瘘、感染及出血等并发症比较,术中血管损伤的预防和处理尚有一定重视不足。术前认真进行影像学评估,术中对可能变异肝动脉的识别及解剖性分离是防范动脉损伤的基本要求。静脉损伤多在术中探查过程中发生,包括胃结肠干、肠系膜上静脉、脾静脉等的损伤,通过压迫止血、无损伤线缝合、预置阻断带等方法予以确切修复。胰十二指肠切除术中对相关血管的处理既要有预见性,更要有确定性。The pancreaticoduodenectomy is not only the classical operation,but also the complex and challenging operation. The intraoperative prevention and treatment for the vessels injury is not paid close attention compared with postoperative pancreatic fistula,infection and bleeding. The preoperative imaginary assessment, intraoperative identification and anatomic isolation would be the basic requirement for preventing the arterial injury, especially for the occasion of the arterial anomalies. The vein injury occurred during the courses of abdominal exploration, including the injury of the gastrocolic trunk, superior mesenteric vein,splenic vein and so on. The injury could be controlled and repaired by compression hemostasis,sewing with noninvasive sutures,occlusion tourniquet. Foreseeability and accuracy are necessary for handling the vessels injury during the pancreaticoduodenectomy.

关 键 词：胰十二指肠切除术 血管损伤 

分 类 号：R6[医药卫生—外科学]