中华肝脏外科手术学电子杂志Issue(6)：13-16,4.DOI:10.3877/cma.j.issn.2095-3232.2014.06.003
全动脉优先离断法在Ⅱ型胰头癌根治性切除中的应用价值
Application value of "total arterial devascularization ifrst" in radical resection of typeⅡpancreatic head carcinoma
摘要
Abstract
ObjectiveTo evaluate the application value of "total arterial devascularization first" (TADF) in radical resection of typeⅡ pancreatic head carcinoma.MethodsClinical data of 86 patients with typeⅡ pancreatic head carcinoma undergoing radical pancreatoduodenectomy by TADF in Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology from May 2012 to January 2014 were analyzed retrospectively. There were 51 males and 35 females with the age ranging from 42 to 78 years and median age of 65 years. The informed consents of all patients were obtained and the ethical committee approval was received. The pancreatic vessels in all the patients were treated by TADF. Occluding bands of the superior mesenteric vein (SMV)/portal vein (PV) and superior mesenteric artery (SMA) were preset. Pancreatic neck was cut off. Along the anterior, right, posterior surfaces of SMA, vessels and neural connective tissues between pancreatic head and SMA, celiac aorta were totally dissected and cut off. The involved SMV/PV were stripped or resected, and reconstructed. Then the en-bloc tumor was removed. The perioperative situation was observed including operative completion, surgical procedures, intraoperative blood loss and postoperative complications.ResultsRadical pancreatoduodenectomy was performed successfully in all 86 cases. The operation duration was 4.6-8.3 h, intraoperative blood loss was 200-600 ml. The operation included SMV sidewall resection and repair (n=26), SMV resection and end to end anastomosis (n=12). No death case was observed during the perioperative period. The incidences of postoperative hemorrhage, pancreatic ifstula were 6% (5/86), 8% (7/86) respectively.ConclusionsApplying TADF in radical resection of typeⅡ pancreatic head carcinoma can ensure the safety of operation, reduce the intraoperative blood loss, improve the general and radical resection rates, and decrease the SMV/PV accidental cutting rate.关键词
胰腺肿瘤/胰头癌分型/胰十二指肠切除术/全动脉优先离断术/术后并发症Key words
Pancreatic neoplasms/Classification of the pancreatic head carcinoma/Pancreatoduodenectomy/Total arterial devascularization ifrst/Postoperative complication引用本文复制引用
王敏,朱峰,田锐,石程剑,彭丰,徐盟,秦仁义..全动脉优先离断法在Ⅱ型胰头癌根治性切除中的应用价值[J].中华肝脏外科手术学电子杂志,2014,(6):13-16,4.基金项目
国家自然科学基金面上项目（81272659）；国家自然科学基金青年基金 （）
