门静脉型环状胰腺研究进展

Current status of research on circumportal pancreas

门静脉型环状胰腺(CPP)指胰腺钩突部与胰体部融合,造成胰腺组织完全环绕门静脉及(或)其主干属支(如肠系膜上静脉、脾静脉)的变异。CPP是罕见的先天性胰腺变异,无临床症状,不需要治疗,易被忽视。其主要的诊断方式是增强CT、MRI检查和手术探查。根据胰腺包绕血管情况和主胰管与门静脉关系,CPP可分为Karasaki分型和Joseph分型。在胰十二指肠切除术和胰体尾切除术中,因胰腺组织包绕门静脉,可能造成残余2个胰腺断面,增加胰肠吻合的难度和术后胰瘘风险。外科医生应知晓此种变异类型,并设计个体化的胰腺手术方式。

Portal annular pancreas(circumportal pancreas,CPP)refers to the fusion of the uncinate process of the pancreas with the body of the pancreas,resulting in the variation of pancreatic tissue completely surrounding the portal vein and/or its main branches(e.g.,superior mesenteric vein,splenic vein).CPP is a rare congenital pancreatic mutation that has no clinical symptoms,does not require treatment,and is easily neglected.The main diagnostic methods are enhanced CT,MRI,and surgical exploration.CPP can be classified by Karasaki classification and Joseph classification according to the condition of vessels wrapping and the relationship between main pancreatic duct and portal vein.During pancreaticoduodenectomy and distal pancreatectomy,the pancreatic tissue surrounding the portal vein may result in two pancreatic sections,increasing the difficulty of pancreatoenterostomy and the risk of postoperative pancreatic fistula.Pancreatic surgeon should be aware of the type of mutation and design a personalized approach in pancreatic surgery.