外科理论与实践2024，Vol.29Issue(5)：426-433,8.DOI:10.16139/j.1007-9610.2024.05.10
隐匿性胰胆反流的胆胰管汇合部解剖模拟分析:基于Fluent研究
Anatomical simulation analysis of pancreaticobiliary junction in occult pancreaticobiliary reflux:based on Fluent study
吕贝宁 1侯念宗 1项雨凯 1达选博 1杨玉龙 1田伏洲2
作者信息
- 1. 同济大学附属东方医院胆石病中心,上海 200120
- 2. 西部战区总医院全军普通外科中心,四川 成都 610083
- 折叠
摘要
Abstract
Objective Computational fluid dynamics software combined with finite element method was used to conduct 2D numerical simulation of pancreaticobiliary junction,and analyze the influence of biliopancreatic ampullary diaphragm,opening direction and shape of duodenal papilla on occult pancreaticobiliary reflux(OPBR).Methods The data of anatomical structure of pancreaticobiliary junction were obtained from online information.Pancreaticobiliary junction was reconstructed in 2D by computational fluid dynamics Fluent 2020R2 software.Different models were drawn for the pancreaticobiliary junction according to the following parameters:biliopancreatic ampullary diaphragm(with/without),opening direction of duodenal papilla(biased to the side of bile duct/central/biased to the side of pancreatic duct).A total of 6 models were used to analyze the risk factors for OPBR.Results When the anatomical structure of the biliopancreatic duct confluence was normal,that was,the ampullary diaphragm exists,no matter how the shape of the duodenal papilla and the opening direction changed,there was no pancreaticobiliary reflux.When the common channel was>5 mm due to the absence of the ampullary diaphragm and duodenal papilla was biased to the side of bile duct,a small amount of pancreatic juice refluxed into the lower end of the bile duct.When the common channel was>5 mm due to the absence of the ampullary diaphragm and duodenal papilla open position was in the middle of the biliopancreatic duct,the velocity and flow rate of pancreatic juice entering bile duct increased,and the degree of reflux was maintained at the lower end of the bile duct.When the common channel was>5 mm due to the absence of the ampullary diaphragm and the duodenal papilla was biased to the side of pancreatic duct,the degree of pancreaticobiliary reflux was more serious,and pancreatic juice reflux was observed throughout the entire bile duct.On the basis of this reflux model,the length of common channel of biliopancreatic duct was shortened,and the opening of outflow tract was enlarged,and the phenomenon of pancreaticobiliary reflux disappeared.Conclusions Based on the Fluent study,it is found that anatomical structures such as ampullary diaphragm and duodenal papilla were closely related to the occurrence of OPBR.Pancreaticobiliary reflux can be terminated by shortening the common channel length of pancreaticobiliary junction and expanding the opening of outflow tract.关键词
计算流体力学/壶腹隔膜/ANSYS Fluent软件/隐匿性胰胆反流Key words
Computational fluid dynamics/Ampullary diaphragm/ANSYS Fluent software/Occult pancreaticobiliary reflux分类
医药卫生引用本文复制引用
吕贝宁,侯念宗,项雨凯,达选博,杨玉龙,田伏洲..隐匿性胰胆反流的胆胰管汇合部解剖模拟分析:基于Fluent研究[J].外科理论与实践,2024,29(5):426-433,8.
