十二指肠返(升)动脉的解剖学

Anatomy of recurrent (ascending) duodenal arteries

目的:调查国人十二指肠返(升)动脉的起源、分支、分布规律,为胃、胰、十二指肠手术提供解剖学资料。方法:动脉乳胶灌注的尸体标本在直视和手术显微镜下行解剖学观察和测量。结果:十二指肠返(升)动脉恒定出现。主要呈二支型(58％)。多数起源于胃十二指肠动脉末端或胃网膜右动脉、胰十二指肠上前动脉近端。根据其分支、分布情况,有3类:幽门十二指肠支(87％)、十二指肠胰支(79％)及单独起源的幽门下动脉(50％)。结论:十二指肠返(升)动脉是幽门及十二指肠上部血供重要来源,建议在PPPD术中尽量保护胃十二指肠动脉主干、胃网膜右动脉及胰十二指肠上前动脉起始部,以保障被保留的幽门及十二指肠残端的血供。

Objective : To investigate the origin, branches and distribution of the recurrent (ascending) duodenal arteries, providing anatomic data for the pylorus-preserving pancreaticoduodenectomy (PPPD). Methods : The cadavers, with arteries injected with latex rubber, were studied by means of gross and surgical microscopy dissection. Results : The recurrent (ascending) duodenal arteries were found in all 24 cases and mainly had the type 2 branches(54%). They depart mainly from the termination of the gastric duodenal artery (GDA) or/and the cranial sides of the right gastroepiploic artery (RGEA) and the anterior superior pancreaticoduodenal artery (ASPDA). The recurrent (ascending) duodenal arteries could be categorized into the pyloric duodenal branch, the duodenalpancreatic branch and the independent infrapy-loric artery according to branches and distribution. Conclusion : The recurrent( ascending) duodenal arteries are the important arteries of the anterior and inferior aspect of the pylorus and the duodenal upon part. The findings suggest it can prevent the ischemia of the duodenal stump after operation to preserve these arteries during PPPD.