【摘要】：目的:為傳統(tǒng)胰頭與十二指腸的切除術(shù)和腹腔鏡胰頭十二指腸切除術(shù)提供應(yīng)用解剖學(xué)依據(jù)。 方法:(1)動(dòng)脈灌注紅色乳膠的防腐尸體20具,觀測(cè)胰頭周圍毗鄰;(2)從全部20例標(biāo)本中連同十二指腸和脾取出全胰,重點(diǎn)研究胰頭區(qū)的血供;(3)在離體標(biāo)本中選取9例胰頭標(biāo)本進(jìn)行胰頭內(nèi)部血供的研究;(4)胰頭十二指腸動(dòng)脈鑄型標(biāo)本5例,與尸體標(biāo)本對(duì)照研究胰頭區(qū)及胰頭內(nèi)部的血供規(guī)律;(5)進(jìn)行腹腔動(dòng)脈和腸系膜上動(dòng)脈造影,顯示兩動(dòng)脈之間在胰頭區(qū)的吻合及血供分布,進(jìn)行對(duì)比研究。 結(jié)果:(1)胰頭的毗鄰:①胰頭前面由淺至深依次為胃、網(wǎng)膜囊和橫結(jié)腸系膜所覆蓋;②后面走行有下腔靜脈、右腎靜脈和膽總管,其中膽總管可在胰頭后表面或?qū)嵸|(zhì)中穿行;③左側(cè)與腸系膜上動(dòng)、靜脈相毗鄰,并伴行有迷走神經(jīng)腹腔支;④上方緊鄰腹腔干其分支肝總動(dòng)脈;⑤右上角緊鄰胃幽門竇和十二指腸上部,胃十二指腸血管經(jīng)兩者之間的間溝向下走行;⑥下面為十二指腸水平部包繞。(2)胰頭十二指腸區(qū)的血供:①血供十分豐富,分別來自腹腔干和腸系膜上動(dòng)脈的分支在兩者前后均形成動(dòng)脈弓,營(yíng)養(yǎng)胰頭部的動(dòng)脈也是十二指腸的主要血供來源。②前動(dòng)脈弓有2種變異;它與十二指腸的距離在前上動(dòng)脈發(fā)出處為18.0mm,在大乳頭下1.47cm處轉(zhuǎn)入間溝中,在與胰頭右側(cè)緣交角處為12.0mm;前動(dòng)脈弓在走行中向外發(fā)出12條分支到十二指腸前壁,向內(nèi)發(fā)出4條分支到胰頭內(nèi)部;③胰
[Abstract]:Objective: to provide anatomic basis for traditional and laparoscopic pancreaticoduodenectomy. Methods: (1) 20 embalmed cadavers with red latex infused by artery were observed adjacent to the head of pancreas, and (2) the whole pancreas was removed from all 20 specimens, including duodenum and spleen. The study focused on the blood supply of the pancreatic head region; (3) the study of the internal blood supply of the pancreatic head in 9 cases of isolated specimens; (4) the study of the blood supply of the duodenal artery of the head of the pancreas in 5 cases; Compared with the cadaveric specimens, the blood supply of the head of pancreas and the interior of the head of pancreas were studied. (5) the celiac artery and the superior mesenteric artery were performed to show the anastomosis and blood supply distribution between the two arteries in the pancreatic head area. Results: (1) from superficial to deep in front of head of pancreas, there were inferior vena cava, right renal vein and common bile duct. The common bile duct could pass through the posterior surface or parenchyma of pancreatic head. (3) the left side was adjacent to the superior mesenteric artery and vein and was accompanied by the vagus nerve, the abdominal branch of the vagus and the superior corner of the common hepatic artery, which was adjacent to the gastric pyloric sinus and the upper part of the duodenum, in the upper corner of the common hepatic artery, which was a branch of the celiac trunk. The gastroduodenal vessels go downwards through the sulcus between them. (2) the blood supply of the duodenal region of the pancreatic head and the duodenum is very abundant. The branches from the celiac trunk and superior mesenteric artery formed the arterial arch before and after, and the artery of the head of the pancreas was also the main blood supply source of the duodenum, and there were two variations in the arch of the anterior artery of the duodenum. The distance from the duodenum to the duodenum is 18.0 mm at the origin of the anterior superior artery, 12.0 mm at the angle with the right margin of the head of the pancreas into the intersecting sulcus at the 1.47cm under the great papilla, and 12 branches outward from the arch of the anterior artery to the anterior wall of the duodenum. 4 branches to the inside of the head of the pancreas
【學(xué)位授予單位】：第一軍醫(yī)大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2005
【分類號(hào)】：R322

【引證文獻(xiàn)】

相關(guān)碩士學(xué)位論文 前1條

1 王華;胰十二指腸區(qū)火棉膠包埋薄型化斷層的應(yīng)用解剖學(xué)研究[D];天津醫(yī)科大學(xué);2010年

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本文編號(hào)：2140490