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Titolo:
Practical guidelines for the preservation of the pancreaticoduodenal arteries during duodenum-preserving resection of the head of the pancreas: Clinical experience and a study using resected specimens from pancreaticoduodenectomy
Autore:
Kim, SW; Kim, KH; Jang, JY; Park, S; Park, YH;
Indirizzi:
Seoul Natl Univ Hosp, Coll Med, Dept Surg, Chongno Ku, Seoul 110744, SouthKorea Seoul Natl Univ Hosp Seoul South Korea 110744 , Seoul 110744, SouthKorea
Titolo Testata:
HEPATO-GASTROENTEROLOGY
fascicolo: 37, volume: 48, anno: 2001,
pagine: 264 - 269
SICI:
0172-6390(200101/02)48:37<264:PGFTPO>2.0.ZU;2-M
Fonte:
ISI
Lingua:
ENG
Keywords:
duodenum-preserving resection of the head of the pancreas; pancreaticoduodenectomy;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
15
Recensione:
Indirizzi per estratti:
Indirizzo: Kim, SW Seoul Natl Univ Hosp, Coll Med, Dept Surg, Chongno Ku, 28 Yongon Dong, Seoul 110744, South Korea Seoul Natl Univ Hosp 28 Yongon Dong Seoul South Korea 110744 orea
Citazione:
S.W. Kim et al., "Practical guidelines for the preservation of the pancreaticoduodenal arteries during duodenum-preserving resection of the head of the pancreas: Clinical experience and a study using resected specimens from pancreaticoduodenectomy", HEP-GASTRO, 48(37), 2001, pp. 264-269

Abstract

Background/Aims: The purpose of this study was to create a practical guideline for vascular preservation during duodenum-preserving resection of the head of the pancreas. Methodology: We examined the anatomy of pancreaticoduodenal arteries by specimen angiography and dissection using 12 pancreaticoduodenectomy specimens. We also reviewed our experiences with duodenum-preserving resection of the head of the pancreas. Results: In the specimens, the posterior pancreatiuodenal artery and its duodenal branches were easily separated from the posterior surface of the pancreas, and its papillary branch was identified in two-thirds of the cases. It was difficult to dissect the anterior superior pancreaticoduodenal arteries from the pancreas because they were partially buried in the pancreaticparenchyma. The anterior inferior pancreaticoduodenal artery located in the posterior and inferior surface of the pancreas could be safely dissected in two-thirds of the cases. Duodenum-preserving resection of the head of the pancreas was performed in 7 patients. In every case, the anterior superior pancreaticoduodenal artery was sacrificed and the anterior inferior pancreaticoduodenal artery was preserved. In 3 cases, the entire posterior pancreaticoduodenal artery was preserved and in 4 cases a short segment of the posterior pancreaticoduodenal artery was removed accidentally. The pancreatic head was totally removed and the intrapancreatic common bile duct was preserved. There were 3 postoperative complications, pancreatic leakage, intraabdominal fluid collection and bile duct stricture. They improved with conservative management. Conclusions: To safely perform duodenum-preserving resection of the head of the pancreas, preservation of the whole posterior pancreaticoduodenal artery and anterior inferior pancreaticoduodenal artery is recommended becausethey can be safely dissected from the pancreas, and the posterior pancreaticoduodenal artery provides the major blood supply to the papilla and distal bite duct. However, removal of a short segment of posterior pancreaticoduodenal artery does not preclude a good blood supply to the duodenum becauseof bidirectional blood flow.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 26/09/20 alle ore 11:57:04