Kusano T, Tamai O, Miyazato H, Isa T, Shiraishi M, Muto Y
First Department of Surgery, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan.
Hepatogastroenterology. 1999 Jul-Aug;46(28):2278-80.
A 59 year-old woman with obstructive jaundice secondary to proximal bile duct carcinoma underwent percutaneous transhepatic biliary drainage (PTDB). This revealed complete obstruction of the bifurcation of the hilar hepatic duct and encasement of the right hepatic artery. Wedged hilar hepatectomy with combined resection of the extrahepatic bile duct, gallbladder, and the encased right hepatic artery was performed. The hepatic artery was reconstructed using an in situ right gastroepiploic artery (GEA) pedicle graft. The anastomosis was protected with fatty tissue from the greater omentum. This technique can be used to reconstruct the hepatic artery after radical surgery for malignant hepatobiliary and pancreatic disease.
一名59岁因近端胆管癌继发梗阻性黄疸的女性接受了经皮经肝胆道引流(PTDB)。这显示肝门部肝管分叉处完全梗阻,右肝动脉被包绕。进行了楔形肝门部肝切除术,联合切除肝外胆管、胆囊及被包绕的右肝动脉。使用原位胃网膜右动脉(GEA)蒂移植物重建肝动脉。吻合口用大网膜的脂肪组织保护。该技术可用于恶性肝胆胰疾病根治性手术后的肝动脉重建。