Prior selective arteriovenous treatment in radical pancreaticoduodenectomy / 中华消化外科杂志

ABSTRACT

Radical pancreaticoduodenectomy is the most effective method for the treatment of malignant tumor of pancreatic head.Safe and complete resection of the uncinate process of the pancreas is the most difficult and important part in radical pancreaticoduodenectomy.For the past years,we put forward the new idea of prior selective arteriovenous treatment in radical pancreaticoduodenectomy according to whether the portal vein and superior mesenteric vein was invaded by the tumor.Thin slice scan and vessel reconstruction using multidetector spiral CT can accurately evaluate the condition of the blood vessels near the pancreatic tumor and judge whether the tumor was resectable.By exchanging superior mesenteric artery,controlling blood stream of pancreatic uncinate process and using 3 or 4 vascular blocking bands and the integrated radical resection of uncinate process for those patients can be successfully completed.It can reduce the operating bleeding,operating time and the miscut of superior mesenteric vein and (or) superior mesenteric artery,and also avoid postoperative pancreas necrosis,infection and hemorrhage caused by the pancreas uncinate process residues,and theoretically reduces the chance of tumor cells spread.