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左肾静脉移植物在胰十二指肠切除术联合肠系膜上-脾-门静脉汇合处长节段切除术中的潜在应用

Potential use of left renal vein graft in pancreaticoduodenectomy combined with long segmental resection of the superior mesenteric-splenic-portal vein confluence.

作者信息

Choi Sung Hoon, Hwang Ho Kyoung, Kang Chang Moo, Lee Woo Jung

机构信息

Division of Biliopancreas, Department of Surgery, Yonsei University College of Medicine. Seoul, South Korea.

出版信息

JOP. 2011 May 6;12(3):234-40.

Abstract

CONTEXT

Various techniques for reconstruction after superior mesenteric-splenic-portal vein confluence resection during pancreaticoduodenectomy have been introduced. A certain kind of vascular grafting may be necessary especially when long segmental resection of superior mesenteric-splenic-portal vein confluence is required.

CASE REPORT

We herein report the cases of two patients who underwent left renal vein grafting in a pancreaticoduodenectomy with combined resection of the long segment of the superior mesenteric-splenic-portal vein confluence for pancreatic head cancer following neoadjuvant concurrent chemoradiation therapy as well as their long-term outcomes with graft patency without deterioration of renal function.

CONCLUSION

Our experience with these two cases indicates that an autologous interposition graft using the left renal vein may be considered a safe and convenient conduit in the case of long segmental resection of the superior mesenteric-splenic-portal vein confluence during a pancreaticoduodenectomy following preoperative neoadjuvant chemoradiation therapy.

摘要

背景

已经介绍了在胰十二指肠切除术期间进行肠系膜上-脾-门静脉汇合处切除术后的各种重建技术。特别是当需要对肠系膜上-脾-门静脉汇合处进行长节段切除时,可能需要某种血管移植。

病例报告

我们在此报告两例患者的病例,这两名患者在新辅助同步放化疗后,因胰头癌接受了胰十二指肠切除术,并联合切除了肠系膜上-脾-门静脉汇合处的长节段,术中进行了左肾静脉移植,以及其长期预后,移植血管通畅且肾功能未恶化。

结论

我们对这两例病例的经验表明,在术前新辅助放化疗后的胰十二指肠切除术期间,对于肠系膜上-脾-门静脉汇合处长节段切除的情况,使用左肾静脉进行自体间置移植可被认为是一种安全便捷的管道。

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