中国实用外科杂志2026，Vol.46Issue(8)：1050-1054,5.DOI:10.19538/j.cjps.issn1005-2208.2026.08.08
联合门静脉或肠系膜上静脉切除胰十二指肠切除术应用及技术要点
Application and technical points of pancreaticoduodenec-tomy combined with portal vein or superior mesenteric vein resection
摘要
Abstract
Pancreaticoduodenectomy combined with portal vein and/or superior mesenteric vein resection is an important surgical procedure for pancreatic cancer with portal vein-superior mesenteric vein invasion,which can improve the R0 resection rate and prolong patient survival.The complex vascular anatomy and meticulous vascular reconstruction techniques involved impose higher demands on surgeons.Preoperatively,imaging assessment is required to determine the extent of venous invasion and exclude distant metastasis,with strict adherence to surgical indications;intraoperatively,priority should be given to vascular exploration to assess resectability,following the principle of exploration before transection,with individualized preservation and division of the major branches of the portal venous system to maintain gastrointestinal venous return;reconstruction methods-including partial resection with primary closure,segmental resection with end-to-end anastomosis,or interposition grafting-should be selected based on the circumferential extent and length of venous involvement;postoperatively,prevention and management of complications such as hemorrhage,thrombosis,and venous stenosis are essential,with standardized anticoagulation therapy.Furthermore,venous tumor invasion and absence of adjuvant chemotherapy are identified as adverse prognostic factors.Strict indication selection and optimal surgical timing,combined with greater emphasis on comprehensive treatment and perioperative management,are essential to further reduce surgical complications and improve long-term survival.关键词
胰十二指肠切除术/静脉切除/血管重建/胰腺癌/门静脉/肠系膜上静脉Key words
pancreaticoduodenectomy/venous resection/vascular reconstruction/pancreatic cancer/portal vein/superior mesenteric vein分类
医药卫生引用本文复制引用
林健振,蒋奎荣..联合门静脉或肠系膜上静脉切除胰十二指肠切除术应用及技术要点[J].中国实用外科杂志,2026,46(8):1050-1054,5.基金项目
National Natural Science Foundation of China(No.82103235,No.82473412) 国家自然科学基金项目(No.82103235,No.82473412) （No.82103235,No.82473412）
