胰腺血供及其移植血管重建的研究

Clinical study of the arterial blood supply of pancreas and the vascular reconstruction of pancreatic graft

目的了解胰腺动脉及其变异情况,为胰腺移植动脉重建提供理论依据。方法回顾性分析中南大学湘雅二医院2000年1月至2006年2月300例胰腺动脉造影片,统计胰腺动脉的变异情况,并分析其结果。结果(1)300例造影中,仅1例能辨认胰十二指肠上动脉;胰十二指肠上前动脉及上后动脉的变异率分别为6.33%和5.06%。(2)胰十二指肠下动脉及其分支(胰十二指肠下前动脉、胰十二指肠下后动脉)的主要变异是发自第一空肠动脉,其发自第一空肠动脉的变异率分别是19.51%、17.54%及12.28%。(3)胰背动脉变异情况较为复杂,其变异率为23.61%。结论胰腺动脉走行复杂,在胰腺移植供胰的血管重建过程中,所重建的血管应既要能保证全胰十二指肠移植完整的血供又要能够减少术后血栓等外科并发症的发生。

Objective To investigate the arterial blood supply of pancreas and provide the theory for the vascular reconstruction of pancreatic graft. Methods Three hundreds cases of digital subtraction artery （DSA） photograms made between January 2000 and February 2006 in Xiangya Second Hospital of Central South University were analyzed and summarized retrospectively. Results （ 1 ） In 300 DSA photograms, it could identify the superior pancreaieduodenal artery （ SPD. a） only once. The aberration rate of anterior superior pancreaicduodenal artery （ ASPD. a） and posterior superior pancreaicduodenal artery （ PSPD. a） was 6. 33% and 5.06% respectively. （2）The differentiation origin of inferior pancreaicduodenal artery （ IPD. a） and its branches was mostly the 1 st jejunal artery. The aberration rate origin from the 1 st jejunal artery of IPD. a, anterior inferior pancreaicduodenal artery （AIPD. a） and posterior inferior pancreaicduodenal artery （PIPD. a） was 19.51% ,17.54% and 12. 28% respectively. （3）The conditions of dorsal pancreatic artery （ DP. a） was complex. The aberration rate of DP. a was 23.61%. Conclusion The arterial blood supply of pancreas was complex. During the vascular reconstruction of pancreas transplantation,the artery chosen to reconstruct should not only meet with the requiring of integrity blood of pancreas ,but also reduce the incidence of surgical complications.