胰十二指肠切除术步骤 马二民 河南中医药大学第一附属医院 скачать в хорошем качестве

胰十二指肠切除术步骤 马二民 河南中医药大学第一附属医院

胰十二指肠切除术步骤 马二民 河南中医药大学第一附属医院 胰十二指肠切除术首先要探查能不能切除，能不能切除的最主要的几个方面，就是先探肿瘤有没有侵犯下腔，侵犯下腔静脉有多长，有没有其他地方的转移，这在术前要详细的评估，还有就是肿瘤有没有侵犯肠系膜上静脉，侵犯肠系膜上静脉有多少，有没有180度或者是360度或者是侵犯的有多少有多长，能不能切除重建，这只有探查完有没有侵犯或者侵犯多少以后，才知道能不能把胰十二指肠切除完全干净，她切除的范围应该包括远端胃、十二指肠一直到屈氏韧带的小肠，十二指肠，还有一直切到胰颈、胰颈部、胆肠、胰肠尝和胃肠的吻合，这个手术比较复杂。 Pancreatoduodenectomy procedure Pancreatoduodenectomy should be performed first, Can we remove the most important aspects, To find out if the tumor invades the inferior cavity, How long does it invade the inferior vena cava, Is there any other transfer, This needs to be evaluated in detail before surgery, And if the tumor invades the superior mesenteric vein, How much is the invasion of superior mesenteric vein, Is there 180 degrees or 360 degrees or how many violations are there, Can we resect and reconstruct, It's only after we've explored whether or how many violations there are, I wonder if I can get pancreatoduodenectomy completely clean, Her resection should cover the distal stomach, duodenum and the small intestine of the troostal ligament, Duodenum, And then we cut it all the way to the neck of the pancreas, the neck of the pancreas, the gall bladder, the pancreas and the intestines to taste the gastrointestinal anastomosis, The operation is complicated.