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中华腔镜外科杂志(电子版) ›› 2022, Vol. 15 ›› Issue (01): 29 -31. doi: 10.3877/cma.j.issn.1674-6899.2022.01.007

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腹腔镜保留十二指肠的膜内全胰头切除术
冯业晨1, 秦仁义1,()   
  1. 1. 430030 武汉,华中科技大学同济医学院附属同济医院胆胰外科
  • 收稿日期:2022-01-03 出版日期:2022-02-28
  • 通信作者: 秦仁义

Intracapsular approach used in laparoscopic duodenum­preserving total pancreatic head resection

yechen Feng1, Renyi Qin1()   

  • Received:2022-01-03 Published:2022-02-28
  • Corresponding author: Renyi Qin
图1 离断主胰管和(或)副胰管后,胰头部胰腺组织与十二指肠及胆道是可以分离(图源于《奈特人体胚胎学》)
图2 腹腔镜保留十二指肠的膜内全胰头切除术 注:A、B.腹腔后腹膜在十二指肠降部、水平部外侧分为两层,前后两层各自进入十二指肠的前后方,分别位于胰头的后方和下腔静脉的前方;C.在Henle′s干、肠系膜上静脉与十二指肠水平部三角区域的切开胰头固有包膜,紧贴胰腺实质分离胰腺钩突;D.保留胰头背侧的胰腺固有包膜和腹膜前层整个胰头的后方均可从十二指肠前方的后腹膜上分离,其后方的胰十二指肠下动脉、胰背动脉和胆管均可完整保留,只有细小的血管分支进入了胰腺实质;E.保留下来的十二指肠与空肠一样,有完整的血管弓及系膜
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