胰十二指肠切除术中门静脉损伤的修复及防治（Repair and prevention of portal vein injury in pancreaticoduodenectomy）.docVIP

胰十二指肠切除术中门静脉损伤的修复及防治（Repair and prevention of portal vein injury in pancreaticoduodenectomy） Repair and prevention of portal vein injury in pancreaticoduodenectomy Update Date: 2010-10-08, Chen Weiqiang, Chen Yajin, Chen Jisheng From 1985 to December 1996, a total of 72 cases of pancreatoduodenectomy were performed in our hospital, including 6 cases with portal vein injuries, accounting for 8.33% of the surgery during the same period. The analysis is discussed as follows. clinical data There were 4 males and 2 females, aged 29~71 years. Of the 6 cases, there were 4 cases of pancreatic head cancer, 1 cases of lower bile duct carcinoma, and 1 cases of periampullary carcinoma. Intraoperative laceration of pancreatic portal vein (Appendix). 6 cases were found in the operation. During the period of strengthening blood transfusion, fluid infusion and preventing shock, the methods of clamp and finger pressing were used to control the bleeding and repair the damaged blood vessel. The patient recovered well after operation. Schedule 6 cases of portal vein injuries Lesion location (case) treatment prognosis Pancreatic head cancer, posterior portal vein tear (2), suture cleft well Cut injury (1) repair the incision well Tear of splenic vein inlet (1) suture suture was good Posterior portal vein tears in lower bile duct carcinoma (1) suture suture was good Periampullary carcinoma, superior mesenteric vein inlet tear (1), repaired fissure well Discussion Pancreatoduodenectomy is a larger and more complicated operation in abdominal organs. The mortality rate of operation is higher than that of other abdominal organs. Because of its deep anatomy and abundant peripheral vessels, it is especially easy to damage the portal vein and its branches. The proper treatment is related to the prognosis of the patients. 1. reasons of pancreatoduodenectomy in portal vein injury: portal vein in the pancreas by the superior and inferior mesenteric vein and splenic vein merge, a small branch rich