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目的:为行胰腺体尾部切除时寻找主胰管减少胰瘘提供解剖学资料。方法:解剖观测胰腺标本、胰腺动脉与胰管联合铸型标本各10例。结果:主胰管起于胰尾的中部,在胰颈、体、尾部与上缘之间的距离分别为(7.51±1.06)mm,(10.98±1.81)mm,(8.44±1.72)mm。胰腺各横断面上主胰管的后距,胰颈处为(2.15±0.61)mm,距胰颈1cm处的胰体部为(5.84±1.11)mm,2cm处为(6.12±0.93)mm,胰尾处为(7.44±0.86)mm。铸型标本中脾动脉有9例走行于胰腺上缘,与主胰管的距离在胰颈左侧2 cm处为(9.37±1.05)mm,胰体部中点处为(11.72±1.63)mm,胰尾处为(8.98±1.01)mm,脾动脉的位置变异1例。结论:在胰颈左侧2cm处按自下而上、由前往后的顺序分离并结扎主胰管可减少胰体尾切除术后胰瘘的发生。
OBJECTIVE: To provide anatomical data for finding the main pancreatic duct to reduce pancreatic fistula during resection of pancreatic body tail. Methods: Anatomical observation of pancreatic specimens, pancreas and pancreatic duct in combination with the cast specimens of 10 cases. Results: The main pancreatic duct began in the middle of the tail of the pancreas. The distances between the pancreas, body, tail and the upper edge were (7.51 ± 1.06) mm, (10.98 ± 1.81) mm and (8.44 ± 1.72) mm, respectively. The distance from the pancreatic duct to the pancreas in the transverse section of the pancreas was (2.15 ± 0.61) mm, (5.84 ± 1.11) mm at 1 cm from the pancreatic neck and (6.12 ± 0.93) mm at 2 cm, The tail of the tail was (7.44 ± 0.86) mm. There were 9 cases of splenic artery running on the upper edge of the pancreas in the cast specimens. The distance from the main pancreatic duct was (9.37 ± 1.05) mm at the 2 cm left side of the pancreas and (11.72 ± 1.63) mm at the midpoint of the pancreas (8.98 ± 1.01) mm at the tail of the pancreas and 1 case of the splenic artery. Conclusion: 2cm from the left side of pancreas neck is bottom-up. Separation and ligation of the main pancreatic duct from front to back can reduce the incidence of pancreatic fistula after pancreatic tail resection.