自体脾静脉移植在门静脉和肠系膜上静脉联合切除的胰十二指肠切除术中的应用

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。

The use of autologous splenic vein in substituting for the portal vein system resected in pancreaticoduodenectomy

Objective To study the feasibility of a new procedure by transplanting the autologous splenic vein to take the place of the portal vein system resected during the pancreaticoduodenectomy. Methods We reviewed 3 cases using the above mentioned procedure during pancreaticoduodenectomy, in order to elucidate its applicability perspective. Results The operation proved to be mainly satisfatory. The stop-flow time of the portal vein was 52 min,38 min and 30 rain respectively. No splenomegaly nor ascites were noted in the postoperative ultrasonic examination. The portal vein blood flow was normal in all the 3 cases, averaging 1 450 ml/min, 1 200 ml/min and 1 500 ml/min respectively.No thrombosis nor narrowness of the vein were noted by postoperative CTA examination. The quality of life was improved significantly with disappearance of jaundice and abdominal pain. They regained normal liver function and left the hospital in good health. Conclusion It is feasible to substitute with autologous splenic vein for the portal vein system resected during pancreaticoduodenectomy. Such a procedure could increase the resectability rate for some cases of middle to latestage pancreatic cancer and improve their quality of life.