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猫行右半肝及胰头切除术后行胰十二指肠吻合术。

Left pancreaticoduodenostomy after removal of the right lobe and the head of the pancreas in a cat.

机构信息

Department of Surgery, Small Animal, Veterinary Hospital Frégis, Arcueil, France.

出版信息

Vet Surg. 2022 Nov;51(8):1304-1310. doi: 10.1111/vsu.13887. Epub 2022 Sep 13.

Abstract

OBJECTIVE

To report a surgical technique for pancreaticoduodenostomy and its outcomes in a cat.

ANIMALS

A 14-year-old domestic cat.

STUDY DESIGN

Case report.

METHODS

A cat was referred to our hospital with a large abdominal mass. On ultrasonographic examination, this mass was identified as a large fluid-filled cavity in place of the right pancreatic duct and involved the pancreatic and accessory pancreatic ducts. A small echoic cavity was observed in the left pancreatic lobe. Serous fluid was collected from the large cavity. On cytology, the small cavity was consistent with an abscess. A partial left pancreatectomy was performed to remove the abscess. The large cavity was excised with the remnant of the right pancreatic lobe and body. After ligation of the pancreatic ducts, the left pancreatic duct was isolated and an end-to-side pancreaticoduodenostomy was performed.

RESULTS

The cat recovered without complications. Histological examination was consistent with chronic pancreatitis and peripheral inflammation. No evidence of postoperative pancreatic insufficiency was detected on clinical examination or laboratory findings. A focal ampulla-like dilation of the pancreatic duct was noted on ultrasonography, with no other complications at the anastomosis. The cat presented 225 days postoperatively with respiratory distress. Multiple nodules were identified throughout the lung parenchyma on radiographs. Abnormalities on ultrasonographic examination included an enlarged liver infiltrated with nodules. Due to poor prognosis, the cat was euthanized. Final histopathological diagnosis was diffuse carcinoma.

CONCLUSION

Pancreaticoduodenostomy restored pancreaticointestinal continuity after extensive pancreatectomy involving the pancreatic ducts and resulted in long-term survival in the cat reported here.

摘要

目的

报告一种用于胰十二指肠吻合术的手术技术及其在猫中的结果。

动物

一只 14 岁的家猫。

研究设计

病例报告。

方法

一只猫因腹部巨大肿块被转诊至我院。超声检查发现,该肿块取代了右胰管,涉及胰管和副胰管,是一个充满液体的大腔。左胰叶观察到一个小的回声腔。从大腔中采集浆液性液体。细胞学检查显示小腔符合脓肿。进行部分左胰切除术以切除脓肿。切除右胰头和体的剩余部分,连同大腔一起切除。结扎胰管后,分离左胰管并进行胰十二指肠端端吻合术。

结果

猫术后无并发症恢复。组织学检查符合慢性胰腺炎和周围炎症。临床检查和实验室检查均未发现术后胰腺功能不全的证据。超声检查显示胰管局部呈壶腹样扩张,吻合口无其他并发症。术后 225 天,猫出现呼吸窘迫。X 线片显示整个肺实质有多个结节。超声检查的异常包括肝肿大并浸润有结节。由于预后不佳,对猫进行了安乐死。最终的组织病理学诊断为弥漫性癌。

结论

胰十二指肠吻合术在广泛涉及胰管的胰切除术之后恢复了胰肠连续性,并使报告的这只猫长期存活。

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