中华消化外科杂志
中華消化外科雜誌
중화소화외과잡지
Chinese Journal of Digestive Surgery
2015年
10期
866-869
,共4页
陈伟%赖佳明%张昆松%黄力%陈东%陈流华%殷晓煜%梁力建
陳偉%賴佳明%張昆鬆%黃力%陳東%陳流華%慇曉煜%樑力建
진위%뢰가명%장곤송%황력%진동%진류화%은효욱%량력건
胰腺肿瘤%胰十二指肠切除术%肠系膜上静脉%门静脉%血管移植
胰腺腫瘤%胰十二指腸切除術%腸繫膜上靜脈%門靜脈%血管移植
이선종류%이십이지장절제술%장계막상정맥%문정맥%혈관이식
Pancreatic neoplasms%Pancreaticoduodenectomy%Superior mesenteric vein%Portal vein%Vascular grafting
目的 探讨同种异体血管移植在胰十二指肠切除联合肠系膜上静脉和门静脉部分切除术血管重建中的应用价值.方法 回顾性分析2014年8月和10月中山大学附属第一医院收治的2例行胰十二指肠切除联合肠系膜上静脉和门静脉部分切除术的胰头癌患者的临床资料.病例1血型A型,病例2血型O型.术中均发现肿瘤包裹肠系膜上静脉和门静脉,包裹长度分别为6 cm,决定行胰十二指肠切除联合肠系膜上静脉和门静脉部分切除术及同种异体血管(血型B型)移植.采用门诊和电话方式进行随访,随访内容为患者肿瘤转移、复发情况.随访时间截至2015年6月.结果 2例患者均顺利完成手术,围术期无并发症发生.病例1手术时间为480 min,脾静脉阻断时间为45 min,肠系膜上静脉和门静脉阻断时间为30 min,术中出血量为3 000 mL,术中输RBC 10 U,血浆600 mL.血管切除长度为7 cm.术后患者恢复顺利,术后第5天恢复进食,第5、7天拔除腹腔引流管,第21天出院.术后患者至随访截止时间仍生存,未见肿瘤复发.病例2手术时间为480 min,脾静脉阻断时间为30 min,肠系膜上静脉和门静脉阻断时间为25 min,术中出血量为600 mL,术中输RBC 2 U,血浆400 mL.血管切除长度为7 cm.术后患者恢复顺利,术后第5天恢复进食,第5、7天拔除腹腔引流管,第14天出院.至随访截止时间仍生存,未见肿瘤转移和复发.结论 同种异体血管移植应用于胰十二指肠切除联合肠系膜上静脉和门静脉部分切除术的血管重建,安全可行,近期疗效满意.
目的 探討同種異體血管移植在胰十二指腸切除聯閤腸繫膜上靜脈和門靜脈部分切除術血管重建中的應用價值.方法 迴顧性分析2014年8月和10月中山大學附屬第一醫院收治的2例行胰十二指腸切除聯閤腸繫膜上靜脈和門靜脈部分切除術的胰頭癌患者的臨床資料.病例1血型A型,病例2血型O型.術中均髮現腫瘤包裹腸繫膜上靜脈和門靜脈,包裹長度分彆為6 cm,決定行胰十二指腸切除聯閤腸繫膜上靜脈和門靜脈部分切除術及同種異體血管(血型B型)移植.採用門診和電話方式進行隨訪,隨訪內容為患者腫瘤轉移、複髮情況.隨訪時間截至2015年6月.結果 2例患者均順利完成手術,圍術期無併髮癥髮生.病例1手術時間為480 min,脾靜脈阻斷時間為45 min,腸繫膜上靜脈和門靜脈阻斷時間為30 min,術中齣血量為3 000 mL,術中輸RBC 10 U,血漿600 mL.血管切除長度為7 cm.術後患者恢複順利,術後第5天恢複進食,第5、7天拔除腹腔引流管,第21天齣院.術後患者至隨訪截止時間仍生存,未見腫瘤複髮.病例2手術時間為480 min,脾靜脈阻斷時間為30 min,腸繫膜上靜脈和門靜脈阻斷時間為25 min,術中齣血量為600 mL,術中輸RBC 2 U,血漿400 mL.血管切除長度為7 cm.術後患者恢複順利,術後第5天恢複進食,第5、7天拔除腹腔引流管,第14天齣院.至隨訪截止時間仍生存,未見腫瘤轉移和複髮.結論 同種異體血管移植應用于胰十二指腸切除聯閤腸繫膜上靜脈和門靜脈部分切除術的血管重建,安全可行,近期療效滿意.
목적 탐토동충이체혈관이식재이십이지장절제연합장계막상정맥화문정맥부분절제술혈관중건중적응용개치.방법 회고성분석2014년8월화10월중산대학부속제일의원수치적2례행이십이지장절제연합장계막상정맥화문정맥부분절제술적이두암환자적림상자료.병례1혈형A형,병례2혈형O형.술중균발현종류포과장계막상정맥화문정맥,포과장도분별위6 cm,결정행이십이지장절제연합장계막상정맥화문정맥부분절제술급동충이체혈관(혈형B형)이식.채용문진화전화방식진행수방,수방내용위환자종류전이、복발정황.수방시간절지2015년6월.결과 2례환자균순리완성수술,위술기무병발증발생.병례1수술시간위480 min,비정맥조단시간위45 min,장계막상정맥화문정맥조단시간위30 min,술중출혈량위3 000 mL,술중수RBC 10 U,혈장600 mL.혈관절제장도위7 cm.술후환자회복순리,술후제5천회복진식,제5、7천발제복강인류관,제21천출원.술후환자지수방절지시간잉생존,미견종류복발.병례2수술시간위480 min,비정맥조단시간위30 min,장계막상정맥화문정맥조단시간위25 min,술중출혈량위600 mL,술중수RBC 2 U,혈장400 mL.혈관절제장도위7 cm.술후환자회복순리,술후제5천회복진식,제5、7천발제복강인류관,제14천출원.지수방절지시간잉생존,미견종류전이화복발.결론 동충이체혈관이식응용우이십이지장절제연합장계막상정맥화문정맥부분절제술적혈관중건,안전가행,근기료효만의.
Objective To investigate the application value of vascular allotransplantation in the pancreaticoduodenectomy combined with superior mesenteric vein and/or portal vein (SMV/PV) partial resection and vascular reconstruction.Methods The clinical data of 2 patients with pancreatic head carcinoma who underwent pancreaticoduodenectomy combined with SMV/PV partial resection at the First Affiliated Hospital of Sun Yat-sen University between August 2014 and October 2014 were retrospectively analyzed.The blood types of case 1 and case 2 were types A and O.Since SMV/PV surrounded by tumor was detected during the operation with the length of surrounded part of 6 cm, and pancreaticoduodenectomy combined with SMV/PV partial resection and vascular allotransplantation were performed.Two cases were followed up by outpatient examination and telephone interview till June 2015.The index observed during the follow-up included tumor metastasis and recurrence.Results Two cases underwent successful operation without perioperative complications.The operation time,splenic vein occlusion time, SMV/PV occlusion time, volume of intraoperative blood loss, volume of red blood cell (RBC) transfusion, volume of plasma transfusion and length of resected blood vessel were 480 minutes, 45 minutes, 30 minutes, 3 000 mL, 10 U, 600 mL and 7 cm in case 1 and 480 minutes, 30 minutes, 25 minutes,600 mL, 2 U, 400 mL and 7 cm in case 2.Two cases took food at postoperative day 5, abdominal drainage tube was removed at postoperative day 5 and 7 with good recovery.Case 1 and Case 2 were discharged from hospital at postoperative day 21 and 14, respectively.Two cases had good survival without metastasis and recurrence of tumors at the end of follow-up.Conclusion Vascular allotransplantation is safe and feasible in the pancreaticoduodenectomy combined with SMV/PV partial resection for pancreatic head carcinoma, with a satisfactory short-term outcome.
