Department of Hepato-Biliary-Pancreatic and Breast Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan.
Department of Anatomy and Embryology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan.
Surg Today. 2021 Aug;51(8):1410-1413. doi: 10.1007/s00595-021-02255-z. Epub 2021 Feb 27.
To describe the procedure for a left-side approach to the superior mesenteric artery (SMA) during pancreaticoduodenectomy (PD) in a cadaveric study.
After dividing the upper jejunum, the jejunal artery (JA) is followed to its origin. At the cranial side of the JA, the mesojejunum to be dissected is detached from the ventral to the dorsal side and from the peripheral to the origin side of the SMA. The inferior pancreatoduodenal artery (IPDA), which is usually the common trunk of the IPDA and the first JA, is able to be visualized at the cranio-dorsal side of the origin of the JA. After cutting the IPDA, the mesojejunum can be detached from the SMA from the dorsal aspect to the right side. Subsequently, the pancreas head is dissected easily from the right aspect of the SMA.
This left-side approach to the SMA may become a standard procedure.
在尸体研究中描述胰十二指肠切除术（PD）中肠系膜上动脉（SMA）左侧入路的手术步骤。
在上段空肠分离后，追踪空肠动脉（JA）至其起源处。在 JA 的颅侧，将从中线向肠系膜侧和从 SMA 起源侧向外侧分离要解剖的空肠系膜。通常位于 IPDA 和第一 JA 共同干的下胰十二指肠动脉（IPDA）可在 JA 起源的颅背侧看到。切断 IPDA 后，可从 SMA 的背侧向右侧游离空肠系膜。随后，从 SMA 的右侧容易游离胰头。
这种 SMA 的左侧入路可能成为一种标准的手术方法。
