经肠系膜上静脉入路的胰后隧道建立在儿童门静脉海绵样变肝门解剖中的作用
Role of retropancreatic tunnel established by superior mesenteric vein-approach in a child with cavernous transformation of the portal vein during Rex bypass
罗洋 1彭赟 1吴耀星 1谢小龙 1王琦 1吕勇 1李可为 1向波1
作者信息
- 1. 四川大学华西医院小儿外科(成都 610041)
- 折叠
摘要
目的 总结经肠系膜上静脉入路的胰后隧道建立在儿童门静脉海绵样变肝门解剖中的临床运用经验.方法 回顾性分析2023年9月笔者所在医院收治的1例儿童门静脉海绵样变患者的临床资料.笔者团队将提出的经肠系膜上静脉入路的胰后隧道建立方案运用到该患儿的肝门解剖中.结果 该4岁男性门静脉海绵样变患儿术中通过经肠系膜上静脉入路的胰后隧道的建立,快速、安全地定位门静脉,从而简化肝门解剖,成功完成胰腺后方Rex搭桥.手术总时间约8 h,术中出血约60 mL(包括血管吻合时放血).经术后3个月随访,患儿恢复良好,搭桥血管通畅,门静脉高压表现得到纠正.结论 笔者所在团队提出的经肠系膜上静脉入路建立胰后隧道的手术策略可以简化儿童门静脉海绵样变的肝门解剖流程,从而更迅速、安全地寻找到血管吻合部位.
Abstract
Objective To summarize the clinical experience of retropancreatic tunnel established by superior mesenteric vein-approach in a child with cavernous transformation of the portal vein(CTPV)during Rex bypass.Method The retropancreatic tunnel was created by the superior mesenteric vein-approach during Rex bypass in a child with CTPV who was admitted to our hospital in September,2023.Clinical data were retrospectively analyzed.Results For the 4-year-old male child who was diagnosed with CTPV,after the establishment of the retropancreatic tunnel by superior mesenteric vein-approach,the portal vein was quickly identified,thus simplifying the portal dissection.The operation time of Rex bypass was about 8 hours,and intraoperative blood loss was about 60 mL.After a 3-month follow-up,the child recovered well with patent bypass vessels.Conclusion The surgical strategy proposed by our team can simplify the Rex bypass,resulting in more rapid and safe access to the vascular anastomosis site.
关键词
门静脉海绵样变/胰后隧道/肠系膜上静脉/门静脉Key words
cavernous transformation of the portal vein/retropancreatic tunnel/superior mesenteric vein/portal vein引用本文复制引用
基金项目
四川省科技计划重点研发计划(2021YFQ0063)
四川大学高校基本科研业务费专项"从0到1"创新研究项目(2023SCUH0038)
出版年
2024
NETL
NSTL
万方数据