Wang Chun-Xi, Liang Fa-Qi, Chen Gang, Wang Jian-Lie, Song Qing-Bin, Duan Zhi-Quan, Liu Hong-Yi
Department of General Surgery, General Hospital of Chinese People's Liberation Army, Beijing 100853, China.
Zhonghua Yi Xue Za Zhi. 2007 Mar 20;87(11):729-33.
To explore the diagnosis and treatment of the aneurysm in the common trunk of malformed superior mesenteric artery and celiac trunk, especially the approach how to expose and excise such aneurysm.
The clinical data of 6 patients with aneurysm in the common trunk of malformed superior mesenteric artery and celiac trunk, who were operated on under general anesthesia from 1998 to 2006, were analyzed. At first, the body of pancreas was isolated and retracted, the malformed celiac trunk and its ramification were blocked and ablated, the initial part of the celiac trunk and the distant end of left gastric artery were ligated, and then by-pass operation was operated from infra-renal aorta to the visceral arteries (hepatic, splenic, and superior mesenteric arteries) with artificial blood vessels. Follow-up was conducted for 1 - 8 years.
Five cases underwent aneurysm ablation and by-pass from aorta to hepatic, splenic, and superior mesenteric arteries; while 1 case underwent aneurysm ablation and spleen ablation, superior mesenteric artery reconstruction, and by-pass from aorta to hepatic artery simultaneously. All patients were cured without complication and recurrence. No arterial anastomosis stricture or stenosis was found in the 5 patients who received by-pass from aorta to hepatic, splenic, or superior mesenteric artery; however, slight stricture was found at the repaired portion of superior mesenteric artery in another one patient, but without any arterial anastomosis stricture in aorta or hepatic artery.
It is an effective and safe method to treat the aneurysm common trunk of malformed superior mesenteric artery and celiac trunk by using the artificial blood vessel by-pass from aorta to visceral arteries (hepatic, splenic, and superior mesenteric arteries) after controlling the initial part of common trunk and cutting off the aneurysm there.
探讨肠系膜上动脉与腹腔干共干畸形合并动脉瘤的诊断与治疗方法，尤其是该类动脉瘤的显露及切除方法。
分析1998年至2006年期间在全身麻醉下接受手术治疗的6例肠系膜上动脉与腹腔干共干畸形合并动脉瘤患者的临床资料。首先游离并牵开胰体，阻断并切除畸形的腹腔干及其分支，结扎腹腔干起始部及胃左动脉远端，然后用人造血管行肾下腹主动脉与内脏动脉（肝动脉、脾动脉和肠系膜上动脉）的旁路手术。随访1至8年。
5例行动脉瘤切除及主动脉至肝动脉、脾动脉和肠系膜上动脉的旁路手术；1例行动脉瘤切除、脾切除、肠系膜上动脉重建并同时行主动脉至肝动脉的旁路手术。所有患者均治愈，无并发症及复发。5例行主动脉至肝动脉、脾动脉或肠系膜上动脉旁路手术的患者未发现动脉吻合口狭窄；另1例患者肠系膜上动脉修复处有轻度狭窄，但主动脉或肝动脉未发现动脉吻合口狭窄。
在控制共干起始部并切除动脉瘤后，用人造血管行主动脉至内脏动脉（肝动脉、脾动脉和肠系膜上动脉）的旁路手术是治疗肠系膜上动脉与腹腔干共干畸形合并动脉瘤的一种有效且安全的方法。
