近端胃切除术后保留右胃网膜血管的保留幽门胰十二指肠切除术：2例报告
Pylorus-preserving pancreatoduodenectomy preserving the right gastroepiploic vessels following proximal gastrectomy: report of two cases.
作者信息
Hirashita Teijiro, Iwashita Yukio, Nakanuma Hiroaki, Tada Kazuhiro, Saga Kunihiro, Masuda Takashi, Endo Yuichi, Ohta Masayuki, Matsumoto Toshifumi, Inomata Masafumi
机构信息
Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, 1-1 Hasama-machi, Yufu, Oita, 879-5593, Japan.
Department of Surgery, National Hospital Organization Beppu Medical Center, 1473 Uchikamado, Beppu, Oita, 874-0011, Japan.
出版信息
Surg Case Rep. 2019 Mar 12;5(1):41. doi: 10.1186/s40792-019-0599-4.
BACKGROUND
Blood flow of the remnant stomach is supplied via the right gastric and right gastroepiploic vessels after proximal gastrectomy (PG). Whether the remnant stomach can be safely preserved in patients who undergo pylorus-preserving pancreatoduodenectomy (PPPD) after PG remains unclear. We herein report two cases in which the remnant stomach was safely preserved by performing PPPD.
CASE PRESENTATION
The first patient, a 76-year-old man, was diagnosed with cancer of the common bile duct and underwent PPPD 2 years after PG for gastric cancer. The remnant stomach and right gastroepiploic vessels were safely preserved. The second patient, a 56-year-old man with a history of PG for gastric cancer 20 years previously, was diagnosed with cancer of the common bile duct and underwent PPPD. We could safely preserve the remnant stomach and right gastroepiploic vessels.
CONCLUSION
The remnant stomach could be preserved in performing PPPD following PG by preserving the right gastroepiploic vessels.
背景
近端胃切除术后，残胃的血流由胃右血管和胃网膜右血管供应。近端胃切除术后接受保留幽门的胰十二指肠切除术（PPPD）的患者，其残胃是否能够安全保留尚不清楚。我们在此报告两例通过实施PPPD安全保留残胃的病例。
病例介绍
首例患者为一名76岁男性，被诊断为胆总管癌，在因胃癌接受近端胃切除术后2年接受了PPPD。残胃和胃网膜右血管得以安全保留。第二例患者为一名56岁男性，20年前曾因胃癌接受近端胃切除术，被诊断为胆总管癌并接受了PPPD。我们能够安全保留残胃和胃网膜右血管。
结论
通过保留胃网膜右血管，在近端胃切除术后实施PPPD时可以保留残胃。
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