摘要
目的研究胰腺分段的依据,胰腺各段的毗邻、血供特点;探讨移植体最佳胰段的选择和术时避免损伤。方法取50例经防腐处理的成人尸体,用大体解剖方法进行观测。结果胰头血供主要来自胰十二指肠上、下动脉;胰体、尾的血供来自胰背动脉、胰大动脉、胰支和胰尾动脉。胰背动脉起自脾动脉第Ⅰ段占90%,平均长度为1.5 cm;胰大动脉起自脾动脉第Ⅲ段占44%;胰横动脉是胰背动脉的左支;胰尾动脉起自脾动脉的第Ⅳ段或终下动脉。胰头和胰体、尾的血供来源不同,两者虽有吻合,但不能替代。在胰腺下缘肠系膜上动脉发出处向左旁开1 cm,为乏血管区,胰后间隙时有异常肝动脉,其出现率为6%。结论胰头毗邻极其复杂,其血供与十二指肠同源,两者关系密切,胰段移植不宜取胰头;而胰体、尾的血供均来自脾动脉,可取带脾动脉为血管蒂的胰体、尾做为移植段,术时可从乏血管区切断,离断时注意胰后间隙有无异常肝动脉。术时还应避免损伤脾动脉的分支。
Objective To explore the choice of optimal pancreatic segmental graft and to avoid injury during operation on the basis of pancreatic segments,adjacent structures of segments and the characteristics of blood supply.Methods Fifty antisepticized adult cadavers were observed through gross anatomy.Results Blood supply in head of pancreas mainly came from the superior and inferior pancreaticoduodenal arteries and blood supply in the body and tail of pancreas from dorsal pancreatic artery,great pancreatic artery,pancreatic branches and caudal pancreatic artery.The mean length of dorsal pancreatic arteries was 1.5 cm and 90% of them originated from the first segment of splenic artery;44% of great pancreatic artery originated from the third segment of splenic artery.Transverse pancreatic artery was the left branch of dorsal pancreatic artery;artery in tail of pancreas began from the fourth segment of splenic artery or inferior terminal splenic branches.The sources of blood supply in the head and the body and the tail of pancreas were different.There were some anastomoses between them,but they could not replace each other.At the inferior border of pancreas,1 cm from the left side was a vessel-poor region,where the superior mesenteric artery appeared.The frequency of abnormal hepatic artery in the posterior pancreatic space was 6%.Conclusion The border of head of pancreas is extremely complicated.It has the same source of blood supply with duodenum and there is a close connection between them.Therefore,the head of pancreas is not suitable for segmental pancreas transplantation.The blood supply of the body and tail of pancreas originates from splenic artery.So pancreas body and tail with splenic artery as vessel pedicle can be used for segmental transplantation.The transplantation must be cut off from vessel-poor region,and attention should be paid to whether there is any abnormal hepatic artery in the posterior pancreatic space.Injury to the branches of splenic artery should be avoided.
出处
《福建医科大学学报》
2010年第6期433-435,共3页
Journal of Fujian Medical University
基金
福建省自然科学基金(C0610007)
关键词
胰腺
胰段移植
移植
同种
pancreas
pancreas transplantation
transplantation
homologous
