联合门静脉／肠系膜上静脉切除的胰十二指肠切除术

目的 提高侵犯门静脉（PV）／肠系膜上静脉（SMV）的胰头癌的根治性切除率。方法 对11例胰头癌患者施行包括受侵PV／SMV在内的根治性整块切除术。结果 11例患者中3例行血管段切除、人造血管移植术，2例行血管段切除、血管端端吻合术，6例行血管壁楔形切除后修复术。术后并发切口裂开1例，顽固性腹水1例，肝功能损害加重1例，无胆胰漏、出血并发症。临床治愈10例，死亡1例。结论 对单纯侵犯PV／SMV的胰头癌行根治性整块切除术不仅可以完整切除病灶，达到根治性治疗的目的，而且术后并发症发生率及手术病死率并未明显增高，是安全、可行的术式。

Portal/superior mesenteric vein resection in duodenopancreatectomy

Objective To improve the resection rate of pancreatic head cancer invading portal vein(PV)/superior mesenteric vein (SMV).Method Eleven cases of pancreatic head cancer underwent en bloc resection of invaded PV/SMV were reviewed retrospectively.Results In total 11 cases,3 received segment resection of the PV/SMV and artificial vascular graft,2 received segment resection and end to end anastomosis,6 were performed lateral wall partial resection and reconstruction.Postoperative complications included disruption of wound in 1 case,obstinate ascites in 1 case, and aggravation of liver impairment in 1 case.There was no complication of pancreatic leakage or hemorrhage.Ten cases were cured and 1 case died.Conclusions Duodenopancreatectomy with PV/SMV resection not only can resect the tumor wholly,but also decrease the morbidity and mortality,which is a safe and feasible method to treat malignant tumor invaded PV/SMV of pancreatic head cancer.