胰头的动脉分布及其临床意义

The arterial supply of head of pancreas and its clinical significance

目的:为胰头和十二指肠的分部切除提供应用解剖学依据。方法:选取9例动脉灌注乳胶的胰头标本和3例胰头铸型标本对胰头的动脉分布进行解剖学观测。结果:胰头的动脉主要来源于前后动脉弓;其内部动脉可分为浅深两层和钩突部动脉。浅层动脉4条,以第1支最粗大;深层动脉主要由后动脉弓最上的3条分支营养,其中第3分支是最主要营养支;乳头动脉为后上动脉第3分支上发出的二级分支;钩突部的内部血供主要来自胰下动脉的下降支;在胰头内部浅深层及钩突部营养动脉间有着丰富的交通支,形成广泛的吻合。结论:胰十二指肠后上动脉在胰头与十二指肠血供中占据十分重要的位置,在术中保护好该动脉是手术成功与否的重要一环。

Objective： The aim of this study was to clarify arterial supply and the anatomic characteristics of arteries of the head of pancreas, and provide a series of definitive data of those arteries that are well related with pancreatoduodenectomy. Methods： Nine specimen injected with red emulsion into vessels and 3 cast specimen of pancreas were dissected and observed. Results：The arterial supply of the head of pancreas included 3 layers： superficial, deep layer and the layer of uncinate process. 4 major arteries existed in superficial layer in which the first one was the maximum in diameter. Arteries in deep layer were mainly composed of 3 branches from the posterior vascular arch, and the 3rd branch was the most important nutrient artery. Blood supply in uncinate process was mainly originated from the descending branch of inferior pancreatic artery. There were redundant communicating branches between above three portions and widely anastomoses at the plane of pancreatic duct. Conclusions： Posterior superior pancreaticoduodenal artery plays an important role in blood supply of pancreas and duodenum. Protecting effectively this artery will ensure the success of pancreatoduodenectomy.