摘要
目的探讨“钩突优先切除”技术在胰头十二指肠切除术（PD）中的应用价值。方法回顾性分析2010年12月至2011年3月采用先切除胰腺钩突而后再切断胰颈的“钩突优先切除”的PD患者资料。结果共收集19例患者，其中壶腹周围腺癌5例，胰腺癌11例，十二指肠侵袭性纤维瘤病1例，主胰管型导管内乳头状黏液腺瘤（IPMN）和胰腺实性假乳头状瘤（SPTP）各1例。术中发现3例（21％）患者存在异位或副肝右动脉。11例胰腺癌中7例见胰周淋巴结转移，转移淋巴结3～7个，平均4．8个；8例见神经侵犯。所有病例的N16组淋巴结阴性，胰腺断端、胆管切缘、十二指肠切缘和腹膜后切缘等均阴性，全部病例符合％切除。平均门静脉的阻断时间为16min。平均手术时间约4h。无术中大出血等并发症发生，平均失血量约600ml。术后未见顽固性腹泻的发生。结论“钩突优先切除”的PD给术者提供了一个舒适、安全、精确和全程可控的胰头切除方法。
Objective To investigate the value of uncinate process first for pancreaticoduodenectomy （PD）. Methods The clinical data of 19 patients admitted from December 2010 to March 2011, who underwent uncinate process first for PD were studied. Results Among the 19 patients, there were 5 cases of periampullary adenocarcinoma, 11 cases of pancreatic cancer, l case of duodenum aggressive fibromatosis, 1 case of main pancreatic duct type IPMN, 1 case of SPN. During operation, 3 patients （21%） were found to have abnorn3al or aberrant right hepatic artery. Among the 11 patients with pancreatic cancer, there are Peri- pancreatic lymph node（3 ~ 7） metastasis, in 7 cases, and nerve invasion occurred in 8 cases. All the N16 lymph nodes, pancreatic stump, bile duct margin, duodenum and retroperitoneal margin were negative, and all the cases were subjected to Ro resection. The median time for the portal vein blocking was 16 minutes. The average operation time was 4h and there was no major bleeding occurred, and the mean blood loss was 600 ml. No intractable diarrhea occurred post-operatively. Conclusions Uncinate process first for PD offers a comfortable, safe, accurate and controllable method to resect pancreatic head.
出处
《中华胰腺病杂志》
CAS
2012年第1期6-8,共3页
Chinese Journal of Pancreatology
关键词
胰十二指肠切除
技术
钩突
Pancreatieo-duodenectomy
Technique
Uncinate
