Department of Surgery, Nagoya Central Hospital, 3-7-7 Taiko, Nakamura-ku, Nagoya, 453-0801, Japan.
Surg Today. 2021 Nov;51(11):1819-1827. doi: 10.1007/s00595-021-02298-2. Epub 2021 May 20.
The peripancreatic arterial system forms various arterial arcades and collateral branches; therefore, it stands to reason that the arterial supply into the pancreatic head region should be controlled as a whole peripancreatic arterial arcade rather than as the three major supplying arteries during isolated pancreatoduodenectomy (PD). We investigated the clinical importance of early control of the whole peripancreatic arterial arcade during PD.
The subjects of this retrospective study were 63 consecutive patients who underwent PD via a mesenteric approach at our hospital between October, 2014 and February, 2017. The patients were divided into an early control group (n = 27) and a late control group (n = 36) for comparative analysis.
The peripancreatic arterial arcades and collateral branches were seen on preoperative multidetector row computed tomography (CT) images and during PD in all 63 patients. The early control group had significantly less intraoperative blood loss than the late control group. Early control of the whole peripancreatic arterial arcade was an independent factor associated with lower intraoperative blood loss in the multivariable analysis (P = 0.012).
The arterial supply into the pancreatic head region should be controlled as a whole peripancreatic arterial arcade rather than as the three major supplying arteries during isolated PD.
胰周动脉系统形成各种动脉弓和侧支分支；因此，有理由认为，在孤立性胰十二指肠切除术（PD）期间，应该作为整个胰周动脉弓来控制供应胰头部的动脉，而不是作为三大主要供应动脉。我们研究了在 PD 期间早期控制整个胰周动脉弓的临床重要性。
本回顾性研究的对象是 2014 年 10 月至 2017 年 2 月期间在我院接受肠系膜入路 PD 的 63 例连续患者。将患者分为早期控制组（n=27）和晚期控制组（n=36）进行比较分析。
63 例患者的术前多排螺旋 CT（CT）图像和 PD 术中均可见胰周动脉弓和侧支分支。早期控制组的术中出血量明显少于晚期控制组。多变量分析显示，早期控制整个胰周动脉弓是术中出血量减少的独立因素（P=0.012）。
在孤立性 PD 期间，供应胰头部的动脉应作为整个胰周动脉弓来控制，而不是作为三大主要供应动脉。
