胰十二指肠切除联合肠系膜上-门静脉切除后无需血管替代进行端端吻合

Long mesentericoportal vein resection and end-to-end anastmoses without graft in pancreaticoduodenectomy

目的探讨胰十二指肠切除联合大段肠系膜上-门静脉切除后不用血管替代进行端端吻合的可行性和安全性。方法对北京大学临床肿瘤学院自2006年8月至2007年2月采用联合肝脏游离及Cattell-Braasch手法施行胰十二指肠联合5cm以上门静脉-肠系膜上静脉的切除,未采用替代血管而直接行端端吻合的5例胰头癌病人的临床资料进行总结。结果术后所有病人均恢复顺利,无严重手术并发症和围手术期死亡。结论胰十二指肠切除联合大段门静脉-肠系膜上静脉切除后直接进行端端吻合,是安全、可行的一种方法。

Objective To explore the feasibiligy and safety of the operation of pancreaticoduodenectomy combined long mesentericoportal vein resection and end-to-end anastomosis without graft. Methods 5 patients with pancreatic-head adenocarcinoma underwent pancreaticoduodenectomy combined mesentericoportal vein resection from Aug. 2006 to Feb. 2007 in Peking Univeisity School of Oncology. By mobilization of the liver and using Cattell-Braasch maneuver, direct and notension end-to-end anastomosis were easily performed even if the resected mesentericoportal vein 〉 5 cm. Results All 5 patients experienced uneventful recovery,no severe complications occurred. Conclusion Long mesentericoportal vein resection and direct end-to-end anastmoses in pancreaticoduodenectomy are proved to be feasible and safe.