动脉优先入路在胰头癌行胰十二指肠切除术中的应用_高文涛.pdfVIP

· 172 · ()2011 5 5 2 ChinJOperProcGenSurg(ElectronicEdition), May20 11, Vol5, No.2 ·· 高文涛　钱祝银　戴存才　蒋奎荣　吴峻立 郭峰　陈建敏　陆子鹏　蒋军　苗毅 　　 】　　“” 。 　 (SMA), SMA、 、。 　6, 2 、 3 、1 SMA, 2 , 4 (PPPD)。 2 , 、、 。 　“”, , 、。 】　;　;　 Thearteryfirstapproachforresectionofpancreaticheadcancer　 GAOWen-ta,o QIANZhu-yin, DAICun-ca,iJIANGKui-rong, WUJun-l,iGUOFeng, CHEN Jian-min, LUZi-peng, JIANG Jun, MIAOY.iSurgicalCenterofPancreaticDiseas,e FirstAffiliated HospitalofNanjingMedicalUniversity, Nanjing210029, China Correspondingautho:rMIAOY,iEmai:lmiaoy@ Abstract】　 Objective　 Toinvestigatetheapplicationofarteryfirstapproachin resectionofpancreaticheadcance,r andtosummarizetheexperiencewiththisoperative techniqu.e　M ethods　W eperformedanarteryfirstapproachfor6 patientswithpancre- aticheadcance,rwhichrequiresadissectionoftheSMA. Ifitwasresectabl,e radicalresec- tionwasperformedforthenervousandlymphatictissuearoundtheaxisoftheceliacartery andSMA.　 Results　Righ,tleftposterio,randanteriorapproacheswereperformedin2, 3 and1 patient,s respectively.Amongthem, 2 patientsunderwentpalliativehepatojejunosto- m,y and4 receivedpyloruspreservingpancreaticoduodenectomy(PPPD).Exceptfor2 pa- tientswithdelayedgastricemptying, nomajorcomplicationoccured.　 Conclusions　 Ar- teryfirstapproachhasthetheoreticaladvantagewithoutincreaseofcomplication.sHoweve,r itsadvantagesstillneedfurtherclinicalvalidation. Keywords】　 Pancreaticoduodenectom;y　Mesentericartery, superio;r　 Retroper- itonealmargin , R0 , 。 [ 1] (SMA) 。 , R0 　　 DO:I10.3 877/ cma..jissn.1674 -3946.20 11.02.033 　　:210029 , , 　　:, :miaoyi@ ()20 11 5 5 2 ChinJOperProcGenSurg(ElectronicEdition), May2011, Vol5, No.2 · 173 · [ 2] [ 3] 。 Gockel (SMV)、 SMA 3 ～4 cm“” (mesopancreas), , 、。 2010 NCCN, SMA 180 °, (PV)/SMV 、 SM