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联合血管重建胰腺癌根治术 附7例报告 |
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陆维祺 陈福真 符伟国 杨 珏
【摘 要】 目的 探讨联合切除血管和重建的胰腺癌根治术的适应证和方法。方法 对近年来所施行的区域性胰腺切除术、标准胰十二指肠切除术联合肠系膜上静脉切除治疗的 7例胰腺癌作一回顾性分析。结果 2例行区域性胰腺切除术，其中1例联合切除肝动脉，血管端-端吻合，1例联合切除肠系膜 上动脉、肠系膜上静脉，行血管间置移植术；5例行标准胰十二指肠切除术，联合肠系膜上 静脉 切除血管间置移植术。随访8～60个月，情况良好，无胰腺癌复发，彩超和CT显示移植人造 血管通畅。结论 在严格选择的病例中可施行联合切除血管的胰腺癌根治术。
【关键词】 胰腺肿瘤 胰十二指肠切除 门静脉 肠系膜血管
Radical surgery for treatment of pancreatic cancer combined with vessel reconstruction(report of 7 cases).
Lu Weiqi,Chen Fuzhen,Fu Weiguo, et al.Department of Surgery,Zhongsh an Hospital,Shanghai Medical University.Shanghai200032
【Abstract】 Objective To explore the indication and method in treatment of pancreatic cancer using pan createctomy combined resection and reconstruction of blood vessel.Methods We did a retrospective study on the management of 7 cases of pancreatic cancer u sing regional pancreatectomy(RP) and pancreaticoduodenectomy combined resection of superior mesente ric-portal vein(SMPV) in recent years.Results RP was done in 2 cases,one of which received the resection of the hepatic artery followed by end to end anastomosis,another received resection of the superior m esenteric vein and superior mesenteric artery,revascularization was done by mea ns of Dacron graft;pancreaticoduodenectomy combined resection of superior mesent eric-portal vein was done in other 5 cases,sutured by means of a Dacron graft.Fo llow-up was carried out,computed tomography(CT) images and color ultrasonic ima ges proved a fully patent graft 8-60 months after operation and no recurrence.Conclusion The treatment that was regional pancreatectomy(RP) and pancreatectomy combined r esection of blood vessel can be done in carefully selected patients with pancrea tic cancer.
【Key words】 Pancreatic tumor Pancreaticoduodenectomy Portal vein Mesenteric vessel
自1994年4月至1998年8月，我们行联合血管、胰腺切除治疗胰腺癌7例。5例联合切除肠 系膜上静脉－门静脉(superior mesenteric-portal vein,SMPV)，人造血管间置移植。1例 联合切除肠系膜上动脉(superior mesenteric arter[1] [2] [3] [4] 下一页
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