Appleby手术临床应用的解剖学研究

Anatomic study on the clinical application of Appleby operation

目的探讨改良Appleby手术后是否存在胰十二指肠下动脉至肝固有动脉的逆向血流。方法解剖2具新鲜尸体,在腹主动脉发出肠系膜上动脉的远端结扎腹主动脉并插管,在膈肌上方结扎胸主动脉,在肠系膜上动脉发出结肠中动脉的远端结扎肠系膜上动脉。单纯结扎第1具尸体标本的肝总动脉,将第2具尸体标本中腹腔干发出的肝总动脉、脾动脉、胃左动脉自起始部一一结扎。在腹主动脉插管中注入乳胶。结果 2具尸体的肝固有动脉均显示充盈。结论从尸体解剖角度看,由胰十二指肠下动脉至肝固有动脉的逆向血流在理论上是存在的。

Objective To explore whether reverse flow of blood from the inferior pancreaticoduodenal artery to the proper hepatic artery exists after Appleby operation. Methods Two cadavers were used in this study. The aorta abdominalis distal to the superior mesenteric artery was ligated and intubated. Then both the thoracic aorta above the diaphragm and the superior mesenteric artery distal to the middle colic artery were ligated. After ligation of the three branches of the celiac artery in one cadaver or the common hepatic artery alone in the other cadaver, plasticizing dye was injected through centripetal cannula into the abdominal aorta. Results The proper hepatic artery was dyed in both cadavers. Conclusion Theoretically, the reverse flow of blood from the inferior pancreaticoduodenal artery to the proper hepatic artery after Appleby operation has been proven in this anatomic study.