CAJ | 학술논문

目的总结胃十二指肠动脉搭桥重建肝动脉在肝门胆管癌根治术中的应用经验,为肝胆外科医生在肝门部胆管癌手术中正确运用动脉重建方法提供帮助.方法通过胃十二指肠动脉搭桥重建肝动脉的9例患者的临床资料、手术方法及随访结果,回顾分析伴有肝动脉受侵超过2cm的患者肝门部胆管癌根治术中重建肝动脉的临床资料.结果 9例肝门部胆管癌手术,受累动脉均为肝右动脉,动脉受累长度均≥2 cm;所有动脉重建手术均一次性吻合成功,平均吻合时间为(23.0±3.1)min.术后患者胃管引流量及胃肠蠕动功能均无异常表现,术后1周、1个月、3个月常规复查腹部增强CT,术后长期随访无动脉血栓等并发症形成.结论取胃十二指肠动脉移植物作搭桥重建肝动脉能够降低血管重建相关并发症,且对胃肠功能几乎没有影响,是肝门部胆管癌肝动脉重建的最佳选择.
목적 총결위십이지장동맥탑교중건간동맥재간문담관암근치술중적응용경험,위간담외과의생재간문부담관암수술중정학운용동맥중건방법제공방조.방법 통과위십이지장동맥탑교중건간동맥적9례환자적림상자료、수술방법급수방결과,회고분석반유간동맥수침초과2cm적환자간문부담관암근치술중중건간동맥적림상자료.결과 9례간문부담관암수술,수루동맥균위간우동맥,동맥수루장도균≥2 cm;소유동맥중건수술균일차성문합성공,평균문합시간위(23.0±3.1)min.술후환자위관인류량급위장연동공능균무이상표현,술후1주、1개월、3개월상규복사복부증강CT,술후장기수방무동맥혈전등병발증형성.결론 취위십이지장동맥이식물작탑교중건간동맥능구강저혈관중건상관병발증,차대위장공능궤호몰유영향,시간문부담관암간동맥중건적최가선택.
Objective To summarize the clinical experience of hepatic artery bypass reconstruction using gastroduodenal artery in radical resection of hilar cholangiocarcinoma,and to provide assistance for surgeons applying artery reconstruction technique correctly in radical operation of hilar cholangiocarcinoma.Methods 9 cases of hilar cholangiocarcinoma with hepatic artery invasion wcrc subjected to radical resection combined with tumor invaded hepatic artery resection and reconstruction.Hepatic artery bypass reconstruction was performed by end-to end anastomosis,using the gastroduodenal artery interposition graft.The clinical data of these patients were reviewed retrospectively.Results All tumors of these cases with hilar cholangiocarcinoma were involved right hepatic artery,and the in volvement length was not less than 2 cm.The artery reconstruction was one-time successfully per formed in all cases.The median time required for anastomosis was (23.0±3.1) min.No postoperative complications,the dysfunction of gastrointestinal peristalsis or abnormal gastric drainage volume for example,related to the gastro-duodenal artery resection was observed.None of the patients devel oped any complications related to the arterial bypass reconstruction in the follow-up period,which was confirmed by abdominal CT scan.Conclusion Hepatic bypass reconstruction using gastro duodenal artery graft decreases the morbidity related to artery reconstruction and has little effect on gastrointes tinal function,which is the optimal choice for arterial reconstruction in radical operation for hilar cholangiocarcinoma.