论文部分内容阅读
目的探讨“动脉优先”入路在胰头癌行胰十二指肠切除术中的应用范围和技巧。方法先探查肠系膜上动脉(SMA)判断可切除性后,完成以SMA、腹腔干为轴的右侧神经、淋巴组织的完全切除。结果 6例患者中,2例从右侧入路、3例从左后方入路、1例从前方入路完成SMA探查,其中2例行内引流术,另4例完成保留幽门胰十二指肠切除术(PPPD)。术后除2例患者胃排空障碍外,无出血、胰瘘、腹泻等并发症。结论 “动脉优先”入路具有上述理论优势,同时不增加并发症发生率,但其在切缘、预后方面的优势则还需进一步临床验证。
Objective To explore the application range and technique of “arterial priority” approach in pancreaticoduodenectomy. Methods After investigating the superior mesenteric artery (SMA) to determine the resectability, complete resection of the right nerve and lymphoid tissues with SMA and celiac axis as the axis was completed. Results Of the 6 patients, 2 were accessed from the right, 3 from the left posterior, and 1 from the anterior approach to complete SMA exploration, 2 of whom underwent internal drainage and the other 4 completed the preservation of the pylorus-pancreatic duodenum Bowel resection (PPPD). In addition to 2 patients with gastric emptying after surgery, no bleeding, pancreatic fistula, diarrhea and other complications. Conclusion “Arterial priority ” approach has the above theoretical advantages, but does not increase the incidence of complications, but its edge in terms of prognosis is still subject to further clinical validation.