保留十二指肠胰头全切除术  

Duodenum-Preserving Pancreatic Head Total Resection

作　　者：宋宗涛[1] 王槐志 Song Zongtao;Wang Huaizhi(Department of General Surgery,452 Hospital of PLA.Postcode： 610021;Institute of Hepatopanereatobiliary Surgery,Southwest Hospital,Army Medical University.Postcode ： 400038.)

机构地区：[1]解放军452医院普通外科,610021 [2]陆军军医大学西南医院全军肝胆外科研究所,400038

出　　处：《中华普外科手术学杂志（电子版）》2018年第4期288-288,共1页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：西南医院院管课题(SWH2015LCD1;SWH2017ZDCX2004)~~

摘　　要：保留十二指肠胰头全切除术要点:采用柯克手法将胰头从后腹膜分离,直至见到肠系膜下静脉。沿着肠系膜上静脉解剖直至胰颈。结扎切断Henle静脉干。游离、悬吊胃十二指肠动脉,暴露门静脉。缝扎胰腺上下缘、结扎胰头以减少横断胰颈时的出血。切断胰腺勾突,残端缝扎止血。沿着胰头部实质与十二指肠之间的疏松结缔组织解剖,结扎从胰十二指肠动脉弓到胰头的分支。沿着胰头与胆总管之间解剖。切断主胰管,残端用5/0普理灵线缝扎。胰管空肠吻合采用胰管对粘膜吻合法。The main points of duodenum-preserving pancreatic head total resection （DPPHTR） are as follows： To separate pancreatic head from retroperitoneum by Kocher manuveur until we see inferior mesenteric vein. To dissect along SMV until the pancreatic neck. Ligate and cut Henle trunk. To isolate GDA and hang it up, expose portal vein. To suture on the lower and upper edge of pancreas, ligate pancreatic head to decrease bleeding when we cut off the pancreatic neck. To cut off the uncinate of pancreas. The residual end is sutured. To dissect along loose fibrous tissue between duodenum and parenchyma of pancreatic head. Ligate artery branches from pancreaticoduodenal arterial arch to pancreatic head. To dissect between common bile duct and pancreatic head. Cut off the main pancreatic duct and suture its residual end using 5/0 prolene running suture. To perform pancreaticojejunostomy by duct to mucosa anastomosis.

关 键 词：十二指肠 胰腺切除术 要点 

分 类 号：R657.5[医药卫生—外科学]