不同动脉优先入路在腹腔镜胰十二指肠切除术联合肠系膜上静脉和(或)门静脉切除重建的体会  

Experience of different arterial priority approaches in laparoscopic pancreaticoduodenectomy combined with resection and reconstruction of superior mesenteric vein-portal vein

作　　者：王星星 徐杰[1] 王佳国 游科[1] 刘作金[1] WANG Xingxing;XU Jie;WANG Jiaguo;YOU Ke;LIU Zuojin(Department of Hepatobiliary Surgery,The Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,P.R.China)

机构地区：[1]重庆医科大学附属第二医院肝胆外科,重庆400010

出　　处：《中国普外基础与临床杂志》2022年第10期1266-1269,共4页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的 探讨肠系膜上动脉优先入路在腹腔镜胰十二指肠切除术联合肠系膜上静脉(superior mesenteric vein,SMV)-门静脉(portal vein,PV)切除重建中应用的优势。方法 对重庆医科大学附属第二医院2022年4月收治的1例胰头癌伴SMV-PV侵犯患者的手术过程进行总结。结果 本例患者采用肠系膜上动脉右后方入路和前入路相结合的方式完成了腹腔镜胰十二指肠切除术联合SMV-PV切除重建,手术时间7.5 h,术中出血量200 mL,静脉切除重建时间20 min,患者术后第9天好转出院。结论 从本例患者手术过程看,动脉优先入路在胰头癌合并SMV-PV受侵且需切除重建患者中应用是一种安全、有效的入路选择。Objective To investigate the advantage of superior mesenteric artery approach in laparoscopic pancreaticoduodenectomy(LPD) combined with superior mesenteric vein(SMV)-portal vein(PV) resection and reconstruction. Method The operation process of a pancreatic head cancer patient with SMV-PV invasion admitted to the Second Affiliated Hospital of Chongqing Medical University in April 2022 was summarized. Results The resection and reconstruction of SMV-PV during the LPD through the right posterior approach and anterior approach of superior mesenteric artery was completed successfully. The operation time was 7.5 h, the intraoperative blood loss was 200 mL, and the SMV-PV resection and reconstruction time was 20 min. The patient was discharged with a better health condition on the 9th day after operation. Conclusion From the operation process of this patient, the arterial priority approache is a safe and effective approach in the resection and reconstruction of SMV-PV during the LPD.

关 键 词：胰十二指肠切除术 腹腔镜 动脉优先入路 血管重建 

分 类 号：R657.5[医药卫生—外科学]