Sakamoto Katsunori, Iwamoto Yukiharu, Ogawa Kohei, Şal Oğuzhan, Tamura Kei, Hikida Takahiro, Ito Chihiro, Iwata Miku, Sakamoto Akimasa, Shine Mikiya, Nishi Yusuke, Uraoka Mio, Nagaoka Tomoyuki, Honjo Masahiko, Funamizu Naotake, Takada Yasutsugu
Department of Hepato-Biliary-Pancreatic and Breast Surgery, Ehime University Graduate School of Medicine, 454 Kou, Shitsukawa, Toon, Ehime, 791-0295, Japan.
Department of Mechanical Engineering, Ehime University Graduate School of Science and Engineering, 3 Bunkyo-Cho, Matsuyama, Ehime, 790-8577, Japan.
Surg Today. 2025 Mar;55(3):445-451. doi: 10.1007/s00595-024-02903-0. Epub 2024 Jul 30.
This study evaluated the impact of reconstructed portal vein/superior mesenteric vein (PV/SMV) morphology on the long-term nutritional status following pancreatoduodenectomy (PD) using computational fluid dynamics (CFD). Twenty-four patients who underwent PD with PV/SMV resection and reconstruction without tumor recurrence for over 9 months after the operation were enrolled in the study. Three-dimensional models were constructed from computed tomography images obtained 3-6 months postoperatively. The pressure (p) at the inlet and turbulence dissipation rate (ε) at the outlet were investigated in the models. Patients with values of either p or ε above the upper interquartile range were classified as the poor flow group. The prognostic nutritional index improvement rate was significantly lower at 9 postoperative months in the poor flow group than in the good flow group (P = 0.016). This finding indicates the utility of a CFD analysis for evaluating the reconstructed PV/SMV morphology.
本研究使用计算流体动力学（CFD）评估了重建门静脉/肠系膜上静脉（PV/SMV）形态对胰十二指肠切除术（PD）后长期营养状况的影响。本研究纳入了24例行PV/SMV切除及重建且术后9个月以上无肿瘤复发的PD患者。根据术后3 - 6个月获得的计算机断层扫描图像构建三维模型。在模型中研究入口处的压力（p）和出口处的湍流耗散率（ε）。p值或ε值高于上四分位数范围的患者被归类为血流不良组。术后9个月时，血流不良组的预后营养指数改善率显著低于血流良好组（P = 0.016）。这一发现表明CFD分析在评估重建的PV/SMV形态方面具有实用性。
