论文部分内容阅读
目的为提高近端胆管癌和壶腹周围癌的手术切除率，使该区域受肿瘤浸润的血管能一并与肿瘤器官同时切除，并使血管直接重建。方法本组在实施肝门胆管癌切除术及胰十二指肠切除术中，对术中病人的肝蒂内门内的肠系膜上静脉干即“胰后干”（ｐｏｓｔ－ｐａｎｃｒｅａｓ－ｔｒｕｎｋＰＰＴ）进行解剖学定位并进行分段测量长度及可以纵向折叠的长度，以此估计可切除的静脉长度及重新再建血管的长度。结果测量肝蒂内门静脉干１０４例，长度标准差男性５．８±１．９９ｃｍ，女性５．５±０．８１ｃｍ，优势长度大于４．５ｃｍ，男性５６例占７６．７％，女性２５例占８０．６％。胰腺钩突内段肠系膜上静脉干测量５４例长度标准差男性３．７±０．７７ｃｍ，女性３．５±０．６４ｃｍ，优势长度大于３．０ｃｍ者，男性２８例占７７．６％，女性１４例占７７．８％。门静脉纵向折叠移动的范围在１．８～４．２ｃｍ之间，平均折叠２．２ｃｍ者（１．８～２．４）占６６．３％，平均折叠２．８ｃｍ（２．５～４．２）占３３．７％。切除胰十二指肠后胰腺钩突内肠系膜上静脉段纵向折叠范围平均４．０ｃｍ，最长达５．２ｃｍ。结论这二类肿瘤切除术合并受浸血管切除在一定范围是可行的，为联合区域性整块切除术提供?
The purpose is to improve the surgical resection rate of proximal cholangiocarcinoma and periampullar carcinoma so that the tumor infiltrating blood vessels in this area can be simultaneously resected with tumor organs and the blood vessels can be reconstructed directly. Methods This group of patients undergoing hilar cholangiocarcinoma resection and pancreatoduodenectomy, intraoperative patients with intra-hepatic portal vein of the superior mesenteric vein that is “post-pancreas-trunkPPT” Anatomically locate and measure the length of the segment and length can be folded longitudinally, in order to estimate the resectable vein length and re-build the length of the blood vessel. Results 104 cases of portal vein with intrahepatic pedicel were measured. The standard deviation of length was 5.8 ± 1.99cm in male and 5.5 ± 0.81cm in female. The dominant length was more than 4.5cm. 56 cases of male accounted for 76.7% and 25 cases of female Accounting for 80.6%. 54 cases of standard deviation of the length of the superior mesenteric vein in the uncinate process of the pancreas were 3.7 ± 0.77cm in the male and 3.5 ± 0.64cm in the female, and the dominant length was more than 3.0cm. The male 28 cases accounted for 77.6% Female 14 cases accounted for 77.8%. Portal vein longitudinal folding movement in the range of 1.8 ~ 4.2cm, the average folding 2.2cm (1.8 ~ 2.4) accounted for 66.3%, an average of 2.8cm (2.5 ~ 4. 2) 33.7%. Pancreaticoduodenal resection of the superior mesenteric vein segment of the longitudinal fold of the average 4.0cm, up to 5.2cm. Conclusions These two types of tumor resection combined with submerged vascular resection are feasible in a certain range and provide for combined regional lump resection.