Okabayashi Takehiro, Shima Yasuo, Sumiyoshi Tatsuaki, Kozuki Akihito, Tokumaru Teppei, Saisaka Yuichi
Department of Gastroenterological Surgery, Kochi Health Sciences Center. Kochi, Japan.
JOP. 2015 Jan 31;16(1):41-4. doi: 10.6092/1590-8577/2678.
The major goals that must be achieved during pancreaticoduodenectomy (PD) include reduction of postoperative hemorrhage and/or operating time. We herein describe a new technique for PD examining right posterior approach PD.
From January 2012 to December 2013, 116 patients underwent PD for periampullary or pancreatic disease. Of these 116 patients, 56 cases were surgically treated for pancreas head or periampullary malignancy and were studied for blood loss volume and length of operation.
An interesting issue in the present study was related to operating time and intra-operative blood loss. The median blood loss volume and operating time were 349 mL (35-3,636 mL) and 276 min (188-467 min), respectively, in patients who underwent a right posterior-approach PD.
The estimated operative blood loss volume and operative time are lower in right posterior approach PD, probably due to clearly detection a route of the inferior pancreaticoduodenal artery from the SMA and following early ligation of the inferior pancreaticoduodenal artery and reduced congestion of the pancreatic head.
胰十二指肠切除术（PD）期间必须实现的主要目标包括减少术后出血和/或缩短手术时间。我们在此描述一种用于PD的新技术，即右后入路PD。
2012年1月至2013年12月，116例患者因壶腹周围或胰腺疾病接受了PD。在这116例患者中，56例因胰头或壶腹周围恶性肿瘤接受手术治疗，并对失血量和手术时长进行了研究。
本研究中一个有趣的问题与手术时间和术中失血有关。接受右后入路PD的患者，中位失血量和手术时间分别为349毫升（35 - 3636毫升）和276分钟（188 - 467分钟）。
右后入路PD的估计手术失血量和手术时间较低，可能是由于能清晰地从肠系膜上动脉（SMA）找到胰十二指肠下动脉的走行，并尽早结扎胰十二指肠下动脉，减少了胰头充血。
