胰腺系膜外科解剖及组织学观察研究

Study on surgical anatomy and histology of mesopancreas

目的探讨胰腺系膜及其手术相关的解剖学和组织学基础。方法于2016年1-12月在上海交通大学基础医学院完成研究。通过对5具尸体标本胰后间隙、重要血管、后腹膜结构进行解剖观察,并对血管、后腹膜等重要结构进行组织学研究。结果胰后间隙是进行胰腺系膜切除的重要解剖层面。腹腔干、肠系膜上动脉可作为胰腺系膜切除重要的解剖标志。No.16淋巴结在外科解剖上是胰腺系膜外的结构。动脉的外膜与动脉鞘之间存在天然的外科解剖间隙,胰周动脉的动脉鞘上和鞘外有大量的神经、淋巴管分布。结论胰腺系膜切除具备相应的外科解剖学基础;动脉鞘内清扫的策略对于提高清扫效果有一定的解剖学基础。

Objective To investigate the surgical anatomical and histological data for the mesopancreas and mesopancreatic excision. Methods The anatomic structures of the peripancreatic space, the important vessels and the retroperitoneal structures of 5 cadaveric specimens between January and December 2016 in Basic Medicine Faculty of Shanghai Jiao Tong University were observed in the study. The structures of the vessels and retroperitoneum were histological studied. Results Posterior pancreatic space was an important anatomical plane of mesopancreatic excision. Celiac trunk and superior mesenteric artery were important anatomic landmarks of mesopancreatic excision. The No.16 lymph node was the extra anatomy structure of mesopancreas. There was a natural surgical space between the adventitia and sheath of the artery. There was a great deal of nerve and lymphatic vessel distribution on and outside the arterial sheath of the peripancreatic arteries. Conclusion Mesopancreas and mesopancreatic excision have the corresponding basis of surgical anatomy. Arterial sheaths dissection strategy for improving the dissection effect has certain anatomical basis.