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腹腔镜胰十二指肠切除术中门静脉环周胰腺的处理

Management of portal annular pancreas during laparoscopic pancreaticoduodenectomy.

作者信息

Zimmitti Giuseppe, Manzoni Alberto, Ramera Marco, Villanacci Alberta, Sega Valentina, Treppiedi Elio, Guerini Francesca, Garatti Marco, Codignola Claudio, Rosso Edoardo

机构信息

Department of General Surgery, Istituto Ospedaliero Fondazione Poliambulanza, Brescia, Italy.

Department of Radiology and Diagnostic Imaging, Istituto Ospedaliero Fondazione Poliambulanza, Brescia, Italy.

出版信息

J Minim Access Surg. 2018 Oct-Dec;14(4):354-356. doi: 10.4103/jmas.JMAS_235_17.

DOI:10.4103/jmas.JMAS_235_17
PMID:29582803
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6130175/
Abstract

Portal annular pancreas (PAP) is a pancreatic congenital anomaly consisting of pancreatic parenchyma encircling the portal vein and/or the superior mesenteric vein. It has been reported that the risk of developing a post-operative pancreatic fistula is higher following pancreaticoduodenectomy in patients with PAP, probably because of the possibility of leaving undrained a portion of pancreatic parenchyma during the reconstructive phase. Few manuscripts have reported a surgical technique of pancreaticoduodenectomy in case of PAP, herein we report the first case of a patient with PAP undergoing laparoscopic pancreaticoduodenectomy.

摘要

门静脉环状胰腺（PAP）是一种胰腺先天性异常，由环绕门静脉和/或肠系膜上静脉的胰腺实质组成。据报道，PAP患者在胰十二指肠切除术后发生胰瘘的风险更高，这可能是因为在重建阶段可能会有一部分胰腺实质未得到引流。很少有文献报道PAP患者的胰十二指肠切除手术技术，在此我们报告首例接受腹腔镜胰十二指肠切除术的PAP患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/134b/6130175/89b921efbde2/JMAS-14-354-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/134b/6130175/87e56ba5b6c5/JMAS-14-354-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/134b/6130175/89b921efbde2/JMAS-14-354-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/134b/6130175/87e56ba5b6c5/JMAS-14-354-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/134b/6130175/89b921efbde2/JMAS-14-354-g002.jpg

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本文引用的文献

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Laparoscopic pancreatoduodenectomy with superior mesenteric artery-first approach and pancreatogastrostomy assisted by mini-laparotomy.腹腔镜胰十二指肠切除术采用肠系膜上动脉优先入路并辅以迷你剖腹术的胰胃吻合术
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一例极其罕见的门静脉环周胰腺，行胰十二指肠切除术，并特别提及背侧胰腺的胰管处理
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Portal annular pancreas, a notable pancreatic malformation: frequency, morphology, and implications for pancreatic surgery.门静脉环周胰腺，一种显著的胰腺畸形：发生率、形态及对胰腺手术的影响
Surgery. 2009 Sep;146(3):515-8. doi: 10.1016/j.surg.2009.03.018. Epub 2009 May 9.