Villalba M R, Lucas R J
Arch Surg. 1978 Apr;113(4):496-9. doi: 10.1001/archsurg.1978.01370160154026.
The usefulness of the inframesocolic transduodenal approach to the distal biliary system in patients in whom numerous previous procedures had been performed was evaluated. First, the feasibility of the technique was ascertained by anatomic study. Ten anatomic dissections were performed during routine postmortem examinations. This proved that the duodenum, ampulla of Vater, distal common duct, and head of the pancreas could be adequately exposed via the inframesocolic approach and that it was reasonable to use the procedure clinically. This approach has been used successfully in five cases. It was found that (1) the inframesocolic approach to the duodenum and distal biliary system is useful, particularly in those patients requiring second operations in the right upper quadrant; and (2) the approach allows ready access to the area through virgin territory and has distinct advantages in exposure, operative time, and information available.
对那些此前已接受过多次手术的患者，评估经结肠下经十二指肠入路处理远端胆道系统的实用性。首先，通过解剖学研究确定该技术的可行性。在常规尸检过程中进行了十次解剖。这证明经结肠下入路可充分暴露十二指肠、 Vater壶腹、胆总管远端和胰头，且在临床上使用该手术方法是合理的。此入路已成功应用于5例患者。结果发现：（1）经结肠下处理十二指肠和远端胆道系统的入路是有用的，尤其适用于那些需要在上腹右上象限进行二次手术的患者；（2）该入路可通过未被手术干扰的区域轻松进入该部位，在暴露、手术时间和可获取的信息方面具有明显优势。
