动脉入路联合门静脉与脾静脉切除重建的根治性胰十二指肠切除术

摘要

对合并血管侵犯的胰腺恶性肿瘤采用联合血管切除后吻合的根治性切除术治疗,是此类患者在目前阶段获得长期生存的有效治疗手段.然而由于这种手术难度较高、风险较大,外科医师面临巨大挑战.2011年9月哈尔滨医科大学附属第二医院收治1例合并门、脾静脉汇合部受侵犯的胰头癌患者,采用先行动脉入路(以肠系膜上动脉为主线解剖和分离肿瘤及其周围组织)完成了联合门静脉与脾静脉切除重建的根治性胰十二指肠切除术,预后良好.%For patients with malignant pancreatic cancer combined with vascular invasion,radical pancreaticoduodenectomy with vascular resection and anastomosis is the treatment of choice.Because this procedure is difficult to manage and with high risks,it is a great challenge to surgeons.A 50-year old patient with pancreatic head cancer whose portal vein and superior mesenteric vein were involved received radical pancreaticoduodenectomy in the Second Affiliated Hospital of Harbin Medical University.In the surgery,the tumor and its surrounding tissues were dissected,and then the portal vein and splenic vein were reconstructed.The patient was discharged at the 10th day after the surgery with favorable prognosis.