Ishikawa Yoshiya, Ban Daisuke, Matsumura Satoshi, Mitsunori Yusuke, Ochiai Takanori, Kudo Atsushi, Tanaka Shinji, Tanabe Minoru
Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
Department of Molecular Oncology, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
J Hepatobiliary Pancreat Sci. 2017 Jul;24(7):394-400. doi: 10.1002/jhbp.451. Epub 2017 May 3.
Pancreaticoduodenectomy (PD) is the standard surgical procedure for treating pancreatic head cancers. Considerable knowledge of proximal jejunal and pancreatic vein anatomy is a prerequisite for performing PD surgery safely, yet there appear to be no detailed descriptions of first and second jejunal vein (J1V, J2V) anatomy available in the literature.
Adults with hepatobiliary-pancreatic disease underwent multidetector-row computed tomography with intravenous contrast (n = 155), and SYNAPSE 3D (Fujifilm Medical, Tokyo, Japan) was used to generate 3D-CT images.
In 84% of patients, J1V and J2V formed a common trunk (FJT). There were three patterns of branches, related to the presence or absence of FJT formation and the anatomical relationships between the superior mesenteric artery (SMA) and the jejunal veins, as follows: Type 1 (n = 98, 63%) characterized by an FJT located dorsal to SMA; Type 2 (n = 32, 21%), where the FJT was located ventral to the SMA; and Type 3 (n = 25, 16%), where J1V and J2V each drained separately into the SMV.
J1V and J2V usually formed an FJT, and separate J1V and J2V drainage into the SMV was uncommon. Preoperative information on individual patient venous anatomy would increase the safety of the PD procedure.
胰十二指肠切除术（PD）是治疗胰头癌的标准外科手术。充分了解空肠近端和胰静脉解剖结构是安全实施PD手术的前提条件，但目前文献中似乎尚无关于第一和第二空肠静脉（J1V、J2V）解剖结构的详细描述。
对患有肝胆胰疾病的成年人进行了静脉注射造影剂的多排螺旋计算机断层扫描（n = 155），并使用SYNAPSE 3D（富士胶片医疗，日本东京）生成三维CT图像。
在84%的患者中，J1V和J2V形成一个共同干（FJT）。根据FJT的形成情况以及肠系膜上动脉（SMA）与空肠静脉之间的解剖关系，分支有三种模式，如下：1型（n = 98，63%），其特征为FJT位于SMA的背侧；2型（n = 32，21%），FJT位于SMA的腹侧；3型（n = 25，16%），J1V和J2V分别单独汇入肠系膜上静脉（SMV）。
J1V和J2V通常形成一个FJT，J1V和J2V分别单独汇入SMV的情况并不常见。术前了解个体患者的静脉解剖结构信息将提高PD手术的安全性。
