肝圆韧带全程包裹肝门区动脉在预防腹腔镜胰十二指肠切除术后肝门区动脉性出血中的应用体会  

Experience of wrapping the hepatic portal artery via ligamentum teres hepatis in the prevention of portal arterial hemorrhage after laparoscopic pancreaticoduodenectomy

作　　者：王勇 金浩 陈石磊[1] 胡小四 周帅 朱超 庞青 潘洪涛 刘会春 Wang Yong;Jin Hao;Chen Shilei;Hu Xiaosi;Zhou Shuai;Zhu Chao;Pang Qing;Pan Hongtao;Liu Huichun(Department of Hepatopancreatobiliary Surgery,Anhui No.2 Provincial People’s Hospital,Hefei 230041,China;Department of Hepatopancreatobiliary Surgery,the First Affiliated Hospital of Bengbu Medical College,Bengbu 233004,China)

机构地区：[1]安徽省第二人民医院肝胆胰外科,合肥230041 [2]蚌埠医学院第一附属医院肝胆胰外科,233004

出　　处：《中华普通外科学文献(电子版)》2025年第2期96-100,共5页Chinese Archives of General Surgery(Electronic Edition)

基　　金：安徽省教育厅重点项目(KJ2021A1267)。

摘　　要：目的探索肝圆韧带(LTH)全程包裹肝门区动脉在预防腹腔镜胰十二指肠切除术(LPD)后肝门区动脉性出血中的临床效果。方法回顾性分析2019年9月至2024年6月在蚌埠医学院第一附属医院和安徽省第二人民医院行LPD的127例患者资料,根据是否采用LTH全程包裹肝门区动脉技术分为包裹组(75例)和非包裹组(52例),比较两组患者的围手术期情况。结果两组患者术前的基线资料差异无统计学意义。包裹组患者的手术时间为306(270~356)min,略长于非包裹组[300(290~330)min],差异无统计学意义(Z=0.823,P=0.411)。包裹组术后未发生肝门区动脉性出血,非包裹组5例术后发生肝门区动脉性出血(胃十二指肠动脉4例,肝总动脉1例),差异有统计学意义(χ^(2)=5.180,P=0.023)。结论LTH全程包裹肝门区动脉在LPD中安全易行,可有效预防术后肝门区动脉性出血,值得临床推广。Objective To explore the clinical effect of the technique of wrapping the hepatic portal artery via the ligamentum teres hepatis in the prevention of hepatic portal arterial hemorrhage after laparoscopic pancreaticoduodenectomy(LPD).Methods The data of 127 patients who underwent LPD from September 2019 to June 2024 were retrospectively analyzed and divided into the wrapped group(75 patients)and the non-wrapped group(52 patients).The perioperative data of the two groups were compared to evaluate the clinical effectiveness of this technique.Results There was no significant difference in preoperative data between the two groups.The operative time in the wrapped group was 306(270-356)min,which was slightly longer than[300(290-330)min]in the non-wrapped group,and the difference was not statistically significant(Z=0.823,P=0.411).There was no portal arterial hemorrhage in the wrapped group,while there were 5 cases of portal arterial hemorrhage(4 cases of gastroduodenal artery,1 case of common hepatic artery)in the non-wrapped group,and the difference was statistically significant(χ^(2)=5.180,P=0.023).Conclusion It is safe and feasible to wrap the hepatic portal artery in LPD by ligamentum teres hepatis,which can effectively prevent the incidence of hepatic portal arterial hemorrhage after LPD and is worthy of clinical promotion.

关 键 词：腹腔镜检查 胰十二指肠切除术 肝圆韧带 术后出血 

分 类 号：R657.3[医药卫生—外科学]