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目的:探讨以自体脾静脉重建门静脉系统在联合PV/SMV切除的胰十二指肠切除术中临床应用的可行性。方法:回顾性分析3例胰头癌病人在胰十二指肠切除术中采用脾静脉替代门静脉系移植的应用及其效果。结果:手术均顺利,门静脉阻断时间分别为52min、38min和30min。术后B超随访无脾肿大、腹水等情况,门静脉流量均正常(分别为1450ml/min、1200ml/min和1500ml/min),术后CTA复查显示重建的血管血流通畅,无血栓形成或狭窄,术后生活质量得到明显改善,黄疸消失,肝功能正常,均痊愈出院。结论:在联合PV/SMV切除的胰十二指肠切除术中采用自体脾静脉替代门静脉系的移植是可行的。
Objective: To investigate the feasibility of reconstructing the portal vein system with autologous splenic vein for pancreaticoduodenectomy combined with PV / SMV resection. Methods: A retrospective analysis of 3 cases of pancreatic cancer patients in pancreatoduodenectomy with splenic vein instead of portal vein transplantation and its effect. Results: The operation was successful and the portal vein occlusion time was 52min, 38min and 30min respectively. The postoperative follow-up of B-ultrasound showed no splenomegaly and ascites. The portal venous flow was normal (1450ml / min, 1200ml / min and 1500ml / min respectively). Postoperative CTA showed that the reconstructed blood flow was smooth and thrombus-free Stenosis, postoperative quality of life has been significantly improved, jaundice disappeared, normal liver function, were cured and discharged. CONCLUSIONS: It is feasible to use an autologous splenic vein instead of a portal vein for pancreaticoduodenectomy combined with PV / SMV resection.