胰管铸型标本的临床解剖学特征  

Clinical anatomy of cast specimens of the pancreatic duct

作　　者：王建伟[1] 许静涌[2] 韦军民[2] 张卫光[1] WANG Jian-wei;XU Jing-yong;WEI Jun-min;ZHANG Wei-guang(Department of Human Anatomy and Histology and Embryology,Peking University Health Science Center,Beijing100083,China;Department of General Surgery,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing100730,China)

机构地区：[1]北京大学医学部人体解剖学与组织学胚胎学系,北京100083 [2]北京医院普通外科国家老年医学中心中国医学科学院老年医学研究院,北京100730

出　　处：《解剖学报》2022年第5期633-636,共4页Acta Anatomica Sinica

基　　金：北京市科学技术委员会首都特色诊疗项目(Z181100001718216)。

摘　　要：目的观察人体胰腺胰管和胰腺小叶的分布和结构特点,探讨其临床应用价值。方法解剖3例人体胰腺标本,2例为死亡新鲜人体标本,胰腺整体取材,UW器官保存液即刻灌注,低压冲洗胰管,选择主胰管进行ABS溶液灌注,制作胰管铸型,观察分析胰管的分支分布情况;1例为固定标本,观察其表面和内部结构,并取材石蜡切片行HE染色,观察小叶结构和叶内导管分布情况。结果大体标本显示胰腺由大小不一的小叶结构组成,小叶间为薄层结缔组织,其内有血管和导管分布。胰腺导管铸型结构完整,可清晰显示主导管和叶间导管各级分支。胰腺叶间导管直径变化范围较大,最终以一主干汇入主导管,各主干之间分布相对独立,其远端胰管形成小叶样结构,小叶大小不一,小叶间无交通。HE染色显示胰腺小叶为结缔组织包绕,结缔组织内可见血管和导管结构;胰腺小叶内部也可观察到叶内导管结构。结论人体胰管铸型标本可以清晰显示胰管的分支分布情况,胰管的形态学和小叶结构特点的研究对于理解临床问题具有重要的参考价值。Objective To explore the distribution and structure of pancreatic ducts and lobules in human pancreas and explore their clinical application value.Methods Three human pancreatic specimens were dissected,2 of which were fresh whole pancreas samples which were collected from the donated human body after dead,UW organ preservation solution was immediately perfused,and the pancreatic duct was rinsed at low pressure.The surface and internal structure of 1 case was observed as a fixed specimen.Paraffin sections were taken for HE staining to observe the structure of lobules and the distribution of catheters in the leaves.Results The gross specimen showed that the pancreas was composed of lobules of different sizes,with thin layers of connective tissue between the lobules.The pancreatic duct had a complete cast structure and could be clearly displayed to the main duct and the branches of the interlobular duct.The diameters of the interlobular ducts varied widely,and finally a main trunk flowed into the main duct.Each trunk was distributed independently,and the distal pancreatic duct formed a lobule-like structure with different sizes of lobules and no interlobular communication.HE staining showed that the pancreatic lobules were surrounded by connective tissue,in which vascular and ductal structures were visible.Intralobular duct could also be observed in the pancreatic lobules.Conclusion The cast specimen of the human pancreatic duct can clearly show the branch distribution of the pancreatic duct,and the study of the morphological of the pancreatic duct and lobular structure is of great reference value for understanding the clinical problems.

关 键 词：胰管 铸型标本 胰腺切除 功能保留 胰瘘 临床解剖学 人 

分 类 号：R322[医药卫生—人体解剖和组织胚胎学]